Bon Secours Memorial Regional Medical Center LLC
Organization Active NPI Cardiovascular Disease Physician · Mechanicsville, VA
NPI 1942582010 · NPPES record last updated Dec 9, 2020
Key facts
- NPI
- 1942582010
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Cardiovascular Disease Physician 207RC0000X
- Legal business name
- BON SECOURS MEMORIAL REGIONAL MEDICAL CENTER LLC
- Practice address
- 8243 Meadowbridge Rd
Mechanicsville, VA 23116-2329 - Phone
- (804) 730-1481
- Fax
- (804) 730-8464
- NPI assigned
- Sep 15, 2011
- Organization subpart
- No
Authorized official
- Name
- Wilbur Gay
- Title
- Cfo
- Phone
- (864) 255-1904
Other NPIs on the same Medicare enrollment 23
Practitioners 15
-
Keith Hart, NP
-
Rosanna Hastings, NP
-
Mark F. Warner, M.D.
-
Kathryn Armstrong, FNP
-
Marc A Arnold, N.P.
-
Harpreet Singh Grewal, M.D.
-
Vikas K Rathi, M.D.
-
Lori Danielle Warren, FNP-BC
-
Amy Hunt Wenzel, ANP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040726000687 | VA | Part B Supplier - Clinic/Group Practice | 6507775293 |
Receives reassigned benefits from 75 practitioners 26 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Kilmarnock, VA; Glen Allen, VA; Richmond, VA; Mechanicsville, VA; King William, VA |
National Provider Directory
Locations
430 Clairmont Ct
Colonial Heights, VA 23834
Phone (804) 524-0610
43 William B Graham Ct
Kilmarnock, VA 22482
Phone (804) 435-7735
5875 Bremo Rd
Ste 400
Richmond, VA 23226
Phone (804) 287-3550
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician |
207RC0000X | Yes |
Addresses
Primary practice location
8243 Meadowbridge Rd
Mechanicsville, VA 23116-2329
Mailing address
8580 Magellan Pkwy
Richmond, VA 23227-1149
Phone (804) 433-4705
Other practice location 1
43 William B Graham Ct
Kilmarnock, VA 22482-3852
Phone (804) 435-7735
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| C06115 | Other | VA | GROUP PTAN |
Other names
- Bon Secours Richmond Cardiology Associates
Other providers in Mechanicsville, VA
- Bon Secours Memorial Regional Medical Center Inc
- Bon Secours Memorial Regional Medical Center Inc
- Bon Secours Memorial Regional Medical Center LLC
- Bon Secours Memorial Regional Medical Center LLC
- Bon Secours Memorial Regional Medical Center LLC
- Bon Secours St. Francis Medical Center, Inc.
- Bon Secours St. Francis Medical Center, Inc.
- Bon Secours Virginia Medical Group I, LLC
- Bon Secours Virginia Medical Group I, LLC
- Bon Secours Virginia Medical Group I, LLC
All providers in Mechanicsville, VA · Cardiovascular Disease Physician in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 9, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.