Gwendolin Vakena Tangham, M.D

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

License

0101-254157 Issued in VA

Practice address

50 Medical Park Blvd Ste a
Petersburg, VA 23805-9275

Phone

(804) 765-6766

Fax

(804) 765-6771

NPI assigned

Aug 25, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Infectious Disease

Education

Other

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bon Secours Medical Group Richmond Specialty Care LLCGroup PAC ID 8022440056, 350 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• At Home Care Home health agency, Mechanicsvlle, VA, CCN 497493
• Bon Secours Southside Medical Center Hospital, Petersburg, VA, CCN 490067

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gtangham1156261@direct.bsmhealth.org

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.

• Bon Secours Medical Group Richmond Specialty Care LLC

  • Cardiovascular Disease Physician
  • Richmond, VA
  • NPI 1477112225
  Medicare reassignment Care Compare group NPD
• Bon Secours Medical Group Richmond Specialty Care LLC

  • Durable Medical Equipment & Medical Supplies
  • Midlothian, VA
  • NPI 1841029287
  NPD

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

• Advanced Technologies in Home Care, Inc.

  • Home Health Agency
  • Richmond, VA
  • NPI 1376509430
  Care Compare affiliation
• Bon Secours Mercy Health Petersburg LLC

  • General Acute Care Hospital
  • Petersburg, VA
  • NPI 1720623853
  Care Compare affiliation

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

{
    "created_epoch": "1219622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580860800000",
    "number": "1962659730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8580 MAGELLAN PKWY",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232271149",
            "telephone_number": "804-765-6766",
            "fax_number": "804-765-6771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 MEDICAL PARK BLVD STE A",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238059275",
            "telephone_number": "804-765-6766",
            "fax_number": "804-765-6771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANGHAM",
        "first_name": "GWENDOLIN",
        "middle_name": "VAKENA",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-25",
        "last_updated": "2020-02-05",
        "certification_date": "2020-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "VA",
            "license": "0101-254157",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1962659730",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Linda Patsy Tanguma, CRNA
• Tanikka Mason
• Tanwi Bah Tanwi IV, M.D.
• Ronda Lynn Tate
• Taylor Enhanced Living

• Infectious Disease Physician in Petersburg, VA
• Providers in Petersburg, VA by specialty
• Infectious Disease Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.