Medarva Physician Services LLC

Primary specialty

PodiatristTaxonomy code 213E00000X

Legal business name

MEDARVA PHYSICIAN SERVICES LLC

Practice address

40 Medical Park Blvd Ste a
Petersburg, VA 23805-9289

Phone

(804) 775-4500

NPI assigned

Apr 3, 2012

Organization subpart

Yes

Parent organization

RICHMOND EYE AND EAR HEALTHCARE ALLIANCEAs reported in NPPES

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

Authorized official

Name

Tonya Jenkins

Title

VP

Phone

(804) 775-4500

Specialties & licenses 2

Addresses

Other names 1

• MEDRVA PHYSICIAN SERVICES Doing business as

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Part of

Richmond Eye Ear Health Ca

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Richmond Eye & Ear Health Care

  • Low Vision Rehabilitation Optometrist
  • Richmond, VA
  • NPI 1467623553

  Member Of

  NPD member

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Justin Andrew Phillingane, D.P.M.

  • Podiatrist
  • Petersburg, VA
  • NPI 1548642788
  Medicare reassignment Care Compare group NPD
• Ralph Ramos, DPM

  • Foot & Ankle Surgery Podiatrist
  • Colonial Heights, VA
  • NPI 1659738227

  VA

  Medicare reassignment Care Compare group NPD
• Travis Laron Shaw, MD

  • Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
  • Richmond, VA
  • NPI 1629279047
  NPD

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

{
    "created_epoch": "1333411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754524800000",
    "number": "1962768051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8700 STONY POINT PKWY",
            "address_2": "STE 100",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232351962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 MEDICAL PARK BLVD STE A",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238059289",
            "telephone_number": "804-775-4500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5601 Ironbridge Pkwy Ste 107",
            "address_purpose": "LOCATION",
            "city": "Chester",
            "state": "VA",
            "postal_code": "238317771",
            "country_code": "US",
            "telephone_number": "804-732-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MEDARVA PHYSICIAN SERVICES LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RICHMOND EYE AND EAR HEALTHCARE ALLIANCE",
        "enumeration_date": "2012-04-03",
        "last_updated": "2025-08-07",
        "certification_date": "2025-08-07",
        "status": "A",
        "authorized_official_last_name": "JENKINS",
        "authorized_official_first_name": "TONYA",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "804-775-4500"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEDRVA PHYSICIAN SERVICES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Calvin McIntyre
• Lavonne D McLendon, LPC
• Angela Aikens McMichael, PHARM.D.
• Zebrina Meade
• Med-Trans Corporation
• Medstat Inc
• Michelle Luebehusen Mehfoud, MSPT
• Cassandra Merrick, LPC
• Metro Gardens Enterprises, Inc
• Michael W Lane MD PC

• All providers in Petersburg, VA
• Podiatrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.