NPIMap

Organization Active NPI

Sentara Medical Group

Doing business as Sentara Vascular Specialists

  • Vascular Surgery Physician
  • Suffolk, VA
National Provider Identifier
1982884557
Registry record updated Nov 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
SENTARA MEDICAL GROUP
Doing business as
Sentara Vascular Specialists
Practice address
2790 Godwin Blvd
Ste 305
Suffolk, VA 23434-8151
Phone
(757) 395-1600
Fax
(757) 510-9119
NPI assigned
Nov 12, 2007
Last updated
Nov 9, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2015

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

Authorized official

Name
Mrs. Cindy A Taylor
Title
Manager
Phone
(757) 252-2765

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X NU Primary

Addresses

Primary practice location

2790 Godwin Blvd
Ste 305
Suffolk, VA 23434-8151

Mailing address

2790 Godwin Blvd
Ste 305
Suffolk, VA 23434-8151
Phone (757) 395-1600

Other identifiers 1

IdentifierTypeStateIssuer
C02033OtherVAMEDICARE GROUP NUMBER

Other names 1

  • Sentara Vascular Specialists Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Consultants in Int Medi188 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 15

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 15

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1194825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447027200000",
    "number": "1982884557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2790 GODWIN BLVD",
            "address_2": "STE 305",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234348151",
            "telephone_number": "757-395-1600",
            "fax_number": "757-510-9119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2790 GODWIN BLVD",
            "address_2": "STE 305",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234348151",
            "telephone_number": "757-395-1600",
            "fax_number": "757-510-9119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENTARA MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-12",
        "last_updated": "2015-11-09",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "CINDY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "757-252-2765",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "C02033",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sentara Vascular Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Suffolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.