NPIMap

Individual provider Active NPI

Richard L Gergoudis, MD

  • Family Medicine Physician
  • Richmond, VA
National Provider Identifier
1962441881
Registry record updated Nov 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101043513 Issued in VA
Practice address
1800 Glenside Dr
Ste 110
Richmond, VA 23226-3769
Phone
(804) 288-1800
Fax
(804) 288-0515
NPI assigned
Jun 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101043513 VA Primary

Addresses

Primary practice location

1800 Glenside Dr
Ste 110
Richmond, VA 23226-3769

Mailing address

1800 Glenside Dr
Suite 105
Richmond, VA 23226-3769
Phone (804) 288-0399

Other identifiers 4

IdentifierTypeStateIssuer
080182275OtherVAMEDICARE RAILROAD
P00703817OtherVARR MEDICARE
141471OtherVAANTHEM
005635306MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090218000542 VA Practitioner - Family Practice 0345314167 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Virginia School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Commonwealth Primary CareGroup PAC ID 2264420918, 65 clinicians

Practice addresses (Care Compare)

1800 Glenside Dr
Suite 110
Richmond, VA 23226-3769
Phone (804) 288-1800

Hospital & facility affiliations

  • At Home Care Home health agency, Mechanicsvlle, VA, CCN 497493
  • Bayada Home Health Care - Yorktown Home health agency, Yorktown, VA, CCN 497607
  • Westminster Canterbury Corporation Home health agency, Richmond, VA, CCN 497755
  • Commonwealth Home Care Home health agency, Richmond, VA, CCN 497703
  • James River Home Health Agency Home health agency, Richmond, VA, CCN 497706
  • Athc-Hospice LLC Hospice, Mechanicsville, VA, CCN 491606
  • Henrico Doctors' Hospital Hospital, Richmond, VA, CCN 490118
  • Bon Secours St Marys Hospital Hospital, Richmond, VA, CCN 490059
  • CJW Medical Center Hospital, Richmond, VA, CCN 490112
  • Medical College of Virginia Hospitals Hospital, Richmond, VA, CCN 490032
  • Bon Secours Memorial Regional Medical Center Hospital, Mechanicsville, VA, CCN 490069
  • Sheltering Arms Institute Inpatient rehabilitation facility, Richmond, VA, CCN 493036

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101043513VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Quick Care Center LLC Family Medicine CurrentSince Jan 12, 2010 Accepting new patients
Commonwealth Primary Care Family Medicine CurrentSince Jul 1, 2002 Accepting new patients
First Onsite, LLC Family Medicine Past Accepting new patients
H2U Wellness Centers, LLC Past Accepting new patients
Commonwealth Primary Care Family Medicine Past Accepting new patients

Locations

2200 Pump Rd
Ste 100
Richmond, VA 23233
Phone (804) 741-7141

8923 Three Chopt Rd
Ste 101
Richmond, VA 23229
Phone (804) 288-0057

9930 Independence Park Dr
Ste 101
Richmond, VA 23233
Phone (804) 290-0060

1800 Glenside Dr
Ste 105
Richmond, VA 23226
Phone (804) 288-0399

1800 Glenside Dr
Ste 110
Richmond, VA 23226
Phone (804) 288-1800

3002 Stony Point Rd
Ste A
Richmond, VA 23235
Phone (804) 237-0702

Interoperability endpoints

  • Direct secure messaging: richard.gergoudis@cpcva.eclinicaldirectplus.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 18

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 18

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322006400000",
    "number": "1962441881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 GLENSIDE DR",
            "address_2": "SUITE 105",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232263769",
            "telephone_number": "804-288-0399",
            "fax_number": "804-285-0088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 GLENSIDE DR",
            "address_2": "STE 110",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232263769",
            "telephone_number": "804-288-1800",
            "fax_number": "804-288-0515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERGOUDIS",
        "first_name": "RICHARD",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2011-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101043513",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "080182275",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00703817",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "141471",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005635306",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.