| Bon Secours - Virtual Care | |
|
12320 W Broad St Ste 204 Henrico VA 23233-7603 | |
| (513) 752-8000 | |
| Not Available |
| Full Name | Bon Secours - Virtual Care |
|---|---|
| Speciality | Family Medicine |
| Location | 12320 W Broad St Ste 204, Henrico, Virginia |
| Authorized Official Name and Position | Rodney Neill (COO, MEDICAL GROUP) |
| Authorized Official Contact | 3307208546 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bon Secours - Virtual Care 1701 Mercy Health Pl Cincinnati OH 45237-6147 Ph: (513) 752-8000 | Bon Secours - Virtual Care 12320 W Broad St Ste 204 Henrico VA 23233-7603 Ph: (513) 752-8000 |
| NPI Number | 1730806118 |
|---|---|
| Provider Enumeration Date | 10/26/2022 |
| Last Update Date | 04/26/2023 |
| Medicare PECOS PAC ID | 4688044977 |
|---|---|
| Medicare Enrollment ID | O20230517000406 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730806118 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| Provider Name | Stephanie A Crawford |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043743503 PECOS PAC ID: 9830423284 Enrollment ID: I20190723001468 |
| Provider Name | Mary Nesius |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023201944 PECOS PAC ID: 3870762289 Enrollment ID: I20231102000535 |
| Provider Name | Tiffany Malloy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528549706 PECOS PAC ID: 0941554141 Enrollment ID: I20231102002307 |
| Provider Name | Sarah Kuhnell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730595414 PECOS PAC ID: 8729206248 Enrollment ID: I20231103001692 |
| Provider Name | Anita Haney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528419223 PECOS PAC ID: 9436447281 Enrollment ID: I20231211003692 |
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