Commonwealth Primary Care | |
1800 Glenside Dr Ste 105 Richmond VA 23226-3769 | |
(804) 288-0399 | |
(804) 285-0088 |
Full Name | Commonwealth Primary Care |
---|---|
Speciality | Family Medicine |
Location | 1800 Glenside Dr Ste 105, Richmond, Virginia |
Authorized Official Name and Position | Erika Parrish (BILLING ADMINISTRATOR) |
Authorized Official Contact | 8042880399 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Commonwealth Primary Care 1800 Glenside Dr Ste 105 Richmond VA 23226-3769 Ph: (804) 288-0399 | Commonwealth Primary Care 1800 Glenside Dr Ste 105 Richmond VA 23226-3769 Ph: (804) 288-0399 |
NPI Number | 1750571287 |
---|---|
Provider Enumeration Date | 07/31/2007 |
Last Update Date | 09/15/2011 |
Medicare PECOS PAC ID | 2264420918 |
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Medicare Enrollment ID | O20040503001117 |
Identifier | Type | State | Issuer |
---|---|---|---|
1750571287 | NPI | - | NPPES |
141469 | Other | VA | ANTHEM |
303278 | Other | VA | ANTHEM |
304078 | Other | VA | ANTHEM |
CC6597 | Other | VA | MEDICARE RAILROAD |
141464 | Other | VA | ANTHEM |
141466 | Other | VA | ANTHEM |
141468 | Other | VA | ANTHEM |
CK5367 | Other | VA | MEDICARE RAILROAD |
CJ7063 | Other | VA | MEDICARE RAILROAD |
1141467 | Other | VA | ANTHEM |
CL1914 | Other | VA | MEDICARE RAILROAD |
141465 | Other | VA | ANTHEM |
292413 | Other | VA | ANTHEM |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Daniel W David |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1235104027 PECOS PAC ID: 9537059241 Enrollment ID: I20040317000574 |
Provider Name | Christine D Allan |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1376582213 PECOS PAC ID: 5496743148 Enrollment ID: I20040503001049 |
Provider Name | Todd Joseph Reynolds |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1740263631 PECOS PAC ID: 0648251454 Enrollment ID: I20040527000543 |
Provider Name | James K Zelenak |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1154397156 PECOS PAC ID: 4688655145 Enrollment ID: I20040528001194 |
Provider Name | John K Scott |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1538103114 PECOS PAC ID: 4880678671 Enrollment ID: I20040617001204 |
Provider Name | Karissa L Hackelton |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1740341841 PECOS PAC ID: 8123094547 Enrollment ID: I20040908000229 |
Provider Name | Edward M Saylor |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1134199573 PECOS PAC ID: 7113970948 Enrollment ID: I20050222000168 |
Provider Name | Elizabeth H Lamb |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1306936034 PECOS PAC ID: 7315991262 Enrollment ID: I20050303000739 |
Provider Name | William G Harrington |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1982624862 PECOS PAC ID: 6507895612 Enrollment ID: I20050809000838 |
Provider Name | Angela D Middleton |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1023177052 PECOS PAC ID: 9638108566 Enrollment ID: I20050810000830 |
Provider Name | Margaret R Krebs |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1700845484 PECOS PAC ID: 7416988373 Enrollment ID: I20050830000927 |
Provider Name | Edwin G Robinson |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1306841564 PECOS PAC ID: 0941251383 Enrollment ID: I20061212000633 |
Provider Name | Arpita Aggarwal |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1306939459 PECOS PAC ID: 4183526627 Enrollment ID: I20070302000234 |
Provider Name | Ellen Morye Palen |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1245239938 PECOS PAC ID: 5092812909 Enrollment ID: I20070529000276 |
Provider Name | Douglas V Klassett |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1174557516 PECOS PAC ID: 4082714639 Enrollment ID: I20070711000467 |
Provider Name | Vicki B Latham-solomon |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1023205515 PECOS PAC ID: 9830273010 Enrollment ID: I20080226000881 |
Provider Name | Faiza S Akbar |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1598824542 PECOS PAC ID: 1254419575 Enrollment ID: I20080425000575 |
Provider Name | George J Mehfoud |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1518949791 PECOS PAC ID: 2466521810 Enrollment ID: I20080527000458 |
Provider Name | John F Mills |
---|---|
Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1790738425 PECOS PAC ID: 3476628272 Enrollment ID: I20080813000459 |
Provider Name | Sherri Jackson |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1235346495 PECOS PAC ID: 5991864761 Enrollment ID: I20081107000558 |
Provider Name | Christianne P Mclean |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1407064173 PECOS PAC ID: 6507926110 Enrollment ID: I20081126000368 |
Provider Name | Sheila Mae Garris Wallace |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1477520195 PECOS PAC ID: 4880768605 Enrollment ID: I20090120000248 |
Provider Name | Richard L Gergoudis |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1962441881 PECOS PAC ID: 0345314167 Enrollment ID: I20090218000542 |
Provider Name | Richard S Tate |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1851373013 PECOS PAC ID: 3072686369 Enrollment ID: I20090709000694 |
Provider Name | David B Stein |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1366409302 PECOS PAC ID: 7618040908 Enrollment ID: I20090709000742 |
Provider Name | Sigmund Placid Seiler |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1225087299 PECOS PAC ID: 2365515657 Enrollment ID: I20090710000169 |
Provider Name | Raymond W Morgan |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1669439634 PECOS PAC ID: 6901979293 Enrollment ID: I20090717000341 |
Provider Name | Warren Koontz |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1023090289 PECOS PAC ID: 6800969197 Enrollment ID: I20090724000086 |
Provider Name | Saima Zaidi |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1790992212 PECOS PAC ID: 1658417415 Enrollment ID: I20091008000055 |
Provider Name | Margaret C Westin |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1114960184 PECOS PAC ID: 9638242928 Enrollment ID: I20091026000332 |
Provider Name | Laura J Hunter |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1578520540 PECOS PAC ID: 4385781145 Enrollment ID: I20091027000597 |
Provider Name | James D Foster |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1275590218 PECOS PAC ID: 4082787379 Enrollment ID: I20091027000623 |
Provider Name | Robert Mason Daniels |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1922069889 PECOS PAC ID: 6608940424 Enrollment ID: I20091028000172 |
Provider Name | James R Dageforde |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1437115458 PECOS PAC ID: 6709959091 Enrollment ID: I20091124000286 |
Provider Name | David J Taminger |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1801883301 PECOS PAC ID: 6305942467 Enrollment ID: I20091209000391 |
Provider Name | Brenda E Sawyer |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1255564621 PECOS PAC ID: 8022158260 Enrollment ID: I20091218000090 |
Provider Name | Robert J Dausch |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1528046851 PECOS PAC ID: 6507956000 Enrollment ID: I20100204000214 |
Provider Name | Eric J Haacke Golden |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1013904515 PECOS PAC ID: 6406952563 Enrollment ID: I20100325000504 |
Provider Name | Diane L Johnson |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1306839550 PECOS PAC ID: 3173655446 Enrollment ID: I20100722000155 |
Provider Name | Melanie P Boggs |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1740241603 PECOS PAC ID: 5991829046 Enrollment ID: I20100826000856 |
Provider Name | William R Jeter |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1295774131 PECOS PAC ID: 2860516630 Enrollment ID: I20100831000474 |
Provider Name | Jill Goldman |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1083761480 PECOS PAC ID: 0345429841 Enrollment ID: I20110131000458 |
Provider Name | Jennifer Carr |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1427061605 PECOS PAC ID: 7618152091 Enrollment ID: I20110428000505 |
Provider Name | Jason Welch |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1952317893 PECOS PAC ID: 6204833197 Enrollment ID: I20111018000112 |
Provider Name | Michael Campbell |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1578760377 PECOS PAC ID: 1557515202 Enrollment ID: I20130204000503 |
Provider Name | Lawrence W Gooss |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1508092487 PECOS PAC ID: 7719131424 Enrollment ID: I20130205000457 |
Provider Name | Anuradha Gonuguntla |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1811176704 PECOS PAC ID: 6406971175 Enrollment ID: I20150127001161 |
Provider Name | Tammy J Mantzouris |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1669644001 PECOS PAC ID: 3971742917 Enrollment ID: I20151208000181 |
Provider Name | Jere' Kitchen |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1144365909 PECOS PAC ID: 8527367697 Enrollment ID: I20160425001902 |
Provider Name | Mary E Flemmer |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1346605888 PECOS PAC ID: 9436440997 Enrollment ID: I20160614001760 |
Provider Name | Rama Albaz |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1497192298 PECOS PAC ID: 7012205024 Enrollment ID: I20161006001636 |
Provider Name | Claire W Thomas |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1952746406 PECOS PAC ID: 1456576560 Enrollment ID: I20161031001870 |
Provider Name | Sudhansu Kothary |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1669864856 PECOS PAC ID: 8325353428 Enrollment ID: I20180628001195 |
Provider Name | Charles E Wilkinson |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1386024875 PECOS PAC ID: 6608182985 Enrollment ID: I20180927002972 |
Provider Name | Paige R Rackliffe |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1841277977 PECOS PAC ID: 9335190164 Enrollment ID: I20190225001314 |
Provider Name | Bradley J Rolfe |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1689023624 PECOS PAC ID: 2062706211 Enrollment ID: I20191022001881 |
Provider Name | Marie Neilsen |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1194986299 PECOS PAC ID: 1052580602 Enrollment ID: I20191126002143 |
Provider Name | Brenda W Payne |
---|---|
Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
Provider Identifiers | NPI Number: 1396377727 PECOS PAC ID: 0840627527 Enrollment ID: I20200521001531 |
Provider Name | Hannah Michelle Winston |
---|---|
Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
Provider Identifiers | NPI Number: 1386266625 PECOS PAC ID: 4284059759 Enrollment ID: I20200730002300 |
Provider Name | Kevin Flanigan |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1003987587 PECOS PAC ID: 9931143567 Enrollment ID: I20210329000281 |
Provider Name | Shalom Akauola |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1790289411 PECOS PAC ID: 0749538163 Enrollment ID: I20210913002470 |
Provider Name | Shawn Michael Reid |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1255906608 PECOS PAC ID: 6901202035 Enrollment ID: I20210915000067 |
Provider Name | Lauren C Lyles |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1689179145 PECOS PAC ID: 8426304114 Enrollment ID: I20210929000496 |
Provider Name | Lindsay Raulston Klein |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1962963215 PECOS PAC ID: 6204228505 Enrollment ID: I20220120000932 |
Provider Name | Noralee Beecroft |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1366127904 PECOS PAC ID: 2668828187 Enrollment ID: I20231019002001 |
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