| Bon Secours Memorial Regional Medical Center Llc | |
|
10150 Staples Mill Rd Ste C Glen Allen VA 23060-3452 | |
| (804) 755-7581 | |
| (804) 755-7586 |
| Full Name | Bon Secours Memorial Regional Medical Center Llc |
|---|---|
| Speciality | Specialist |
| Location | 10150 Staples Mill Rd Ste C, Glen Allen, Virginia |
| Authorized Official Name and Position | Wilbur Gay (CFO) |
| Authorized Official Contact | 8645617672 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bon Secours Memorial Regional Medical Center Llc 8580 Magellan Pkwy Richmond VA 23227-1149 Ph: () - | Bon Secours Memorial Regional Medical Center Llc 10150 Staples Mill Rd Ste C Glen Allen VA 23060-3452 Ph: (804) 755-7581 |
| NPI Number | 1881795557 |
|---|---|
| Provider Enumeration Date | 09/26/2006 |
| Last Update Date | 09/03/2020 |
| Medicare PECOS PAC ID | 6507775293 |
|---|---|
| Medicare Enrollment ID | O20040726000687 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881795557 | NPI | - | NPPES |
| Provider Name | Kelly J Maupin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861410086 PECOS PAC ID: 1951393941 Enrollment ID: I20040331000671 |
| Provider Name | Judith Mckenzie |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215902887 PECOS PAC ID: 4284622549 Enrollment ID: I20040504001705 |
| Provider Name | Brian J Foster |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881646651 PECOS PAC ID: 3274513502 Enrollment ID: I20040726000579 |
| Provider Name | Mark D Wood |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1770564601 PECOS PAC ID: 0143295030 Enrollment ID: I20041022000508 |
| Provider Name | Stanley B Czajkowski |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902878507 PECOS PAC ID: 3173417631 Enrollment ID: I20041117000058 |
| Provider Name | Diane Sinnatamby |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1174575732 PECOS PAC ID: 6800845405 Enrollment ID: I20050121000115 |
| Provider Name | Stacey L Epps |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1154391571 PECOS PAC ID: 1759332406 Enrollment ID: I20050210000011 |
| Provider Name | Marshall Cross |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1386621852 PECOS PAC ID: 1052346491 Enrollment ID: I20051004000880 |
| Provider Name | Mark A Gentz |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1033153465 PECOS PAC ID: 9335165869 Enrollment ID: I20060626000158 |
| Provider Name | Scott A Vota |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1497782320 PECOS PAC ID: 5294739744 Enrollment ID: I20060914000271 |
| Provider Name | Douglas A Johnson |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1134150568 PECOS PAC ID: 1658377411 Enrollment ID: I20061018000501 |
| Provider Name | Michael J Wittkamp |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1154334241 PECOS PAC ID: 0244236016 Enrollment ID: I20061018000647 |
| Provider Name | Amit N Gogia |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1831102185 PECOS PAC ID: 2961506480 Enrollment ID: I20070322000350 |
| Provider Name | Mark Warner |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1679531487 PECOS PAC ID: 2668566852 Enrollment ID: I20070919000260 |
| Provider Name | Kumar Abhishek |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1083827018 PECOS PAC ID: 3375631179 Enrollment ID: I20071112000571 |
| Provider Name | Alan L Thurman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1013917186 PECOS PAC ID: 3678653839 Enrollment ID: I20071231000401 |
| Provider Name | Haroon S Hyder |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740470483 PECOS PAC ID: 3779668470 Enrollment ID: I20080305000286 |
| Provider Name | Allen Y Tsui |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194703355 PECOS PAC ID: 4284713538 Enrollment ID: I20080512000404 |
| Provider Name | Joycelyn Sabino Akins |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1992704399 PECOS PAC ID: 2567532518 Enrollment ID: I20080602000901 |
| Provider Name | Edward Vincent Bonyak |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1003878794 PECOS PAC ID: 2961590575 Enrollment ID: I20080801000187 |
| Provider Name | Joseph M Karch |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1588873640 PECOS PAC ID: 2062513286 Enrollment ID: I20080826000481 |
| Provider Name | Charles W Nelson |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1639194913 PECOS PAC ID: 3375649049 Enrollment ID: I20080919000459 |
| Provider Name | Clarence G Childress |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1902996549 PECOS PAC ID: 3971670274 Enrollment ID: I20080929000642 |
| Provider Name | Dariush Ashrafi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659545614 PECOS PAC ID: 0345301453 Enrollment ID: I20090102000073 |
| Provider Name | Mark C Garabedian |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1285792978 PECOS PAC ID: 9830246222 Enrollment ID: I20090422000567 |
| Provider Name | Victor H Agbeibor |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770553224 PECOS PAC ID: 2163528951 Enrollment ID: I20091002000318 |
| Provider Name | Alice J Hirata |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1760466684 PECOS PAC ID: 0547302614 Enrollment ID: I20100127000925 |
| Provider Name | John Newton Clore |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1023108669 PECOS PAC ID: 3779627534 Enrollment ID: I20100217000068 |
| Provider Name | Ruth C Latham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275712333 PECOS PAC ID: 7214026186 Enrollment ID: I20100308000454 |
| Provider Name | Linda E Thurby-hay |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1124104161 PECOS PAC ID: 0042345613 Enrollment ID: I20100322000317 |
| Provider Name | Nau D Domah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558534263 PECOS PAC ID: 7012042542 Enrollment ID: I20100323000049 |
| Provider Name | Mark J Rosenberg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356379564 PECOS PAC ID: 1759417181 Enrollment ID: I20100324001143 |
| Provider Name | Jason P Lee |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295767846 PECOS PAC ID: 7911033899 Enrollment ID: I20100330000913 |
| Provider Name | Cheryl D Jordan-sayles |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114955473 PECOS PAC ID: 1153302435 Enrollment ID: I20100525000341 |
| Provider Name | William F Moore |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902831662 PECOS PAC ID: 6002897386 Enrollment ID: I20100525000374 |
| Provider Name | Michael D Sheehan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972534170 PECOS PAC ID: 9739160011 Enrollment ID: I20100525000429 |
| Provider Name | Kenneth H Roberts |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487620373 PECOS PAC ID: 1254377047 Enrollment ID: I20100609000146 |
| Provider Name | Charles F Payne |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902872880 PECOS PAC ID: 4587734132 Enrollment ID: I20100610000975 |
| Provider Name | Thomas Smith |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1952372112 PECOS PAC ID: 0446383251 Enrollment ID: I20100802000288 |
| Provider Name | Kara A Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710147145 PECOS PAC ID: 5890811343 Enrollment ID: I20100922000422 |
| Provider Name | Jennifer G Smith |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972574770 PECOS PAC ID: 4082730916 Enrollment ID: I20100928000852 |
| Provider Name | Vikas K Rathi |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1194927962 PECOS PAC ID: 2668573965 Enrollment ID: I20110104001017 |
| Provider Name | Michael J Macdougall |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1306921184 PECOS PAC ID: 9537340914 Enrollment ID: I20110217000426 |
| Provider Name | George B Newton |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1457436230 PECOS PAC ID: 8325142839 Enrollment ID: I20110310000798 |
| Provider Name | Mary F Baker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750615282 PECOS PAC ID: 0143405399 Enrollment ID: I20110503000486 |
| Provider Name | Robert Sealand |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1093976227 PECOS PAC ID: 3678750296 Enrollment ID: I20110608000545 |
| Provider Name | Andreya Risser |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154587186 PECOS PAC ID: 3274701628 Enrollment ID: I20110729000443 |
| Provider Name | Lachelle Campbell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184870271 PECOS PAC ID: 9436321106 Enrollment ID: I20121008000557 |
| Provider Name | Lori D Warren |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962719633 PECOS PAC ID: 9234379439 Enrollment ID: I20130711000651 |
| Provider Name | Jonathan S Avula |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407142110 PECOS PAC ID: 2264689918 Enrollment ID: I20140617000618 |
| Provider Name | Jaime D Cunningham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285053678 PECOS PAC ID: 7315162120 Enrollment ID: I20140711002116 |
| Provider Name | Keefe H Lobb |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972890523 PECOS PAC ID: 0143448100 Enrollment ID: I20140904001650 |
| Provider Name | Raquel Appa Falcao |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114219839 PECOS PAC ID: 5496994782 Enrollment ID: I20141020001633 |
| Provider Name | Wendy C Evans |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1093007650 PECOS PAC ID: 7012158488 Enrollment ID: I20141104002730 |
| Provider Name | Philip P Valmores |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1063773778 PECOS PAC ID: 7618295239 Enrollment ID: I20150817000055 |
| Provider Name | Robert M Rose |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730527342 PECOS PAC ID: 4981999885 Enrollment ID: I20160816002747 |
| Provider Name | Rachna Raman |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1710183710 PECOS PAC ID: 5890967236 Enrollment ID: I20161005000926 |
| Provider Name | Debra L Levin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063969236 PECOS PAC ID: 7012295744 Enrollment ID: I20161031001231 |
| Provider Name | Rosanna L Hastings |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699222430 PECOS PAC ID: 1850671009 Enrollment ID: I20161206001541 |
| Provider Name | Jacob M Budny |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1508008665 PECOS PAC ID: 0648496570 Enrollment ID: I20180102002094 |
| Provider Name | Ositadinma L Mbadugha |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801214937 PECOS PAC ID: 3678844420 Enrollment ID: I20180924002598 |
| Provider Name | Jill Sidney Storment |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669945663 PECOS PAC ID: 8628308913 Enrollment ID: I20190930002626 |
| Provider Name | Paula N Allocca |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265751812 PECOS PAC ID: 1557486016 Enrollment ID: I20191009001543 |
| Provider Name | Leann Watson Morales |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1326551060 PECOS PAC ID: 8224466297 Enrollment ID: I20200325002440 |
| Provider Name | Keith Hart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063065373 PECOS PAC ID: 8921431420 Enrollment ID: I20200615002064 |
| Provider Name | Andre Georges Enowtaku |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598298127 PECOS PAC ID: 1850719279 Enrollment ID: I20200917001204 |
| Provider Name | Kara Keefe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932697034 PECOS PAC ID: 9032504832 Enrollment ID: I20220314001674 |
| Provider Name | Christopher P Irwin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427613736 PECOS PAC ID: 9133454002 Enrollment ID: I20220902002091 |
| Provider Name | Yunzhou Li |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619597150 PECOS PAC ID: 1355737255 Enrollment ID: I20231011002053 |
| Provider Name | Jasmine Phylisha Jones |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083242671 PECOS PAC ID: 5092130013 Enrollment ID: I20231013002937 |
| Provider Name | Dixon Lee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598343824 PECOS PAC ID: 4385183300 Enrollment ID: I20240822000432 |
| Provider Name | Megan Szorc |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023854676 PECOS PAC ID: 6002349842 Enrollment ID: I20241031001737 |
Patient First Richmond Physician's Group Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5000 Cox Rd, Suite 100, Glen Allen, VA 23060 Phone: 804-968-5700 Fax: 804-217-7991 | |
Occupational Health Centers Of The Southwest P.a. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9900 W Broad St, Suite C, Glen Allen, VA 23060 Phone: 804-358-0361 | |
Allyalign Health, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10900 Nuckols Rd, Suite 110, Glen Allen, VA 23060 Phone: 804-747-0720 Fax: 804-823-2568 | |
Bon Secours-st. Mary's Hospital Of Richmond, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5207 Hickory Park Dr, Suite A, Glen Allen, VA 23059 Phone: 804-612-2980 Fax: 804-762-7102 | |
Vera Whole Health Wa, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11341 W Broad St, Glen Allen, VA 23060 Phone: 804-655-6011 | |
Glen Allen Medi Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11551 Nuckols Rd Ste C, Glen Allen, VA 23059 Phone: 704-926-7546 | |
Virginia Physicians, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4900 Cox Rd, Suite 150, Glen Allen, VA 23060 Phone: 804-346-1780 Fax: 804-346-1781 |