| Chippenham And Johnston-willis Sports Medicine, Llc | |
|
1115 Boulders Pkwy Ste 110 North Chesterfield VA 23225-4067 | |
| (804) 560-6500 | |
| Not Available |
| Full Name | Chippenham And Johnston-willis Sports Medicine, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1115 Boulders Pkwy Ste 110, North Chesterfield, Virginia |
| Authorized Official Name and Position | Louis Joseph (VICE PRESIDENT) |
| Authorized Official Contact | 6153737630 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chippenham And Johnston-willis Sports Medicine, Llc 500 Hioaks Rd Suite A Richmond VA 23225-4061 Ph: (804) 560-6500 | Chippenham And Johnston-willis Sports Medicine, Llc 1115 Boulders Pkwy Ste 110 North Chesterfield VA 23225-4067 Ph: (804) 560-6500 |
| NPI Number | 1740229608 |
|---|---|
| Provider Enumeration Date | 06/06/2006 |
| Last Update Date | 01/02/2023 |
| Medicare PECOS PAC ID | 5698711356 |
|---|---|
| Medicare Enrollment ID | O20050701000972 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740229608 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QS0010X | Family Medicine - Sports Medicine | (* (Not Available)) | Primary |
| Provider Name | Anthony J Distasio |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1831195353 PECOS PAC ID: 5890735641 Enrollment ID: I20050511000243 |
| Provider Name | Gregory Edmund Jeansonne |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1952344723 PECOS PAC ID: 7517961857 Enrollment ID: I20110512000469 |
| Provider Name | Colin V Crickard |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1770562001 PECOS PAC ID: 0547454324 Enrollment ID: I20151027003089 |
| Provider Name | Ahmad H Fashandi |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1538503545 PECOS PAC ID: 0547491508 Enrollment ID: I20180926004112 |
| Provider Name | Kirstin Marie Mckay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184100018 PECOS PAC ID: 0446501605 Enrollment ID: I20180927000074 |
| Provider Name | Michael Mitry Hadeed |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1164818183 PECOS PAC ID: 2264749506 Enrollment ID: I20210721001403 |
| Provider Name | Carlos C Kennedy |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1104841857 PECOS PAC ID: 2668620097 Enrollment ID: I20220120001546 |
| Provider Name | Maxwell Lewis Winkler |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1548792971 PECOS PAC ID: 9830435403 Enrollment ID: I20230731000508 |
| Provider Name | David Arthur Dalsimer |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1477530848 PECOS PAC ID: 6709780851 Enrollment ID: I20230919000543 |
| Provider Name | Blake Saul |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1770965865 PECOS PAC ID: 2567776867 Enrollment ID: I20231017003890 |
| Provider Name | William Edward Neway |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1114125663 PECOS PAC ID: 8527230135 Enrollment ID: I20231218003848 |
| Provider Name | Jerimie Christopher Caudill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427736289 PECOS PAC ID: 5597115451 Enrollment ID: I20231219002177 |
The Center For Life Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1905 Huguenot Rd Ste 201, North Chesterfield, VA 23235 Phone: 804-362-7761 | |
Bon Secours Chesterfield Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2500 Pocoshock Pl, North Chesterfield, VA 23235 Phone: 804-276-9305 Fax: 804-612-7738 | |
Diabetes, Endocrine And Internal Medicine Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1475 Johnston Willis Dr, North Chesterfield, VA 23235 Phone: 804-272-7564 Fax: 804-272-9325 | |
New Generation Healthcare Providers Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 101 Buford Rd Ste B111, North Chesterfield, VA 23235 Phone: 804-878-0942 | |
Metropolitan Services & Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1905 Huguenot Rd Ste 201, North Chesterfield, VA 23235 Phone: 804-464-2322 Fax: 804-464-2542 | |
Cjw Sports Medicine, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1457 Johnston Willis Dr, North Chesterfield, VA 23235 Phone: 804-560-6500 Fax: 804-560-6505 | |
Richmond Vascular Center, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 173 Wadsworth Dr, North Chesterfield, VA 23236 Phone: 804-864-8346 |