| Visavis Health Care Medical Group Of Va Llc | |
|
11 Dairy Ln Fredericksburg VA 22405-2663 | |
| (929) 491-7333 | |
| Not Available |
| Full Name | Visavis Health Care Medical Group Of Va Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 11 Dairy Ln, Fredericksburg, Virginia |
| Authorized Official Name and Position | Rekha Bhandari (OWNER) |
| Authorized Official Contact | 2127346621 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Visavis Health Care Medical Group Of Va Llc 831 Bedford Ave Ste 530 Brooklyn NY 11205-2801 Ph: () - | Visavis Health Care Medical Group Of Va Llc 11 Dairy Ln Fredericksburg VA 22405-2663 Ph: (929) 491-7333 |
| NPI Number | 1508649278 |
|---|---|
| Provider Enumeration Date | 08/16/2023 |
| Last Update Date | 09/08/2023 |
| Medicare PECOS PAC ID | 7315394798 |
|---|---|
| Medicare Enrollment ID | O20231107000286 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508649278 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Chassidy Leeann Sharp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720475767 PECOS PAC ID: 8022322288 Enrollment ID: I20200630003553 |
| Provider Name | Carissa M Kelly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821307646 PECOS PAC ID: 2264627132 Enrollment ID: I20230825003367 |
| Provider Name | Derek Harpole |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235771874 PECOS PAC ID: 3779914965 Enrollment ID: I20231107000382 |
| Provider Name | Christine Dumont |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417207788 PECOS PAC ID: 8325360910 Enrollment ID: I20231107001151 |
| Provider Name | Jessica Hicks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821675158 PECOS PAC ID: 5395145593 Enrollment ID: I20231110001017 |
| Provider Name | Mariama Hubbard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518946763 PECOS PAC ID: 8628033156 Enrollment ID: I20231222001128 |
| Provider Name | Melvin Garcia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033732284 PECOS PAC ID: 2365861028 Enrollment ID: I20231222001862 |
| Provider Name | Sherdina Hobson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104153055 PECOS PAC ID: 3173431640 Enrollment ID: I20231229001663 |
| Provider Name | Njideka Ikeakor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790111557 PECOS PAC ID: 5294950176 Enrollment ID: I20240214004148 |
| Provider Name | Pramila Baral |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295333144 PECOS PAC ID: 0840603767 Enrollment ID: I20240227001513 |
| Provider Name | Irmalynn Mooneyham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225470057 PECOS PAC ID: 4880838440 Enrollment ID: I20240313000165 |
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