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ALEXANDRA SLEDD MACK M.D. NPI 1174812192


NPI Information

NPI: 1174812192
Provider Name: ALEXANDRA SLEDD MACK, M.D.
Classification: Family Medicine - 207Q00000X
Entity Type: Individual
Organization: EVMS ACADEMIC PHYSICIANS AND SURGEONS HEALTH SERVICES FOUNDATION

PECOS Registration: Yes

Address:
825 FAIRFAX AVE
STE 118
NORFOLK, VA
ZIP 23507
Phone: (757) 446-5955
Get Directions

Alexandra Sledd Mack, M.D. is a family medicine in Norfolk, VA with 13 years of experience. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. Alexandra Sledd Mack, M.D. NPI is 1174812192. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: TULANE UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:2011

The provider's business location address is:

825 FAIRFAX AVE
STE 118
NORFOLK, VA
ZIP 23507-914
Phone: (757) 446-5955
Fax: (757) 446-5196

The NPI 1174812192 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/30/2011 and was last updated on 4/26/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily Medicine0101260428VIRGINIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11174812192OTHERVIRGINIATRICARE/CHAMPUS
21174812192OTHERVIRGINIAOPTIMA HEALTH
3VVL729AMEDICARE PINVIRGINIA
41174812192OTHERVIRGINIAVIRGINIA PREMIER HEALTH PLAN
5P01813201MEDICARE PINVIRGINIA
61174812192OTHERVIRGINIAUSA MANAGED CARE
71174812192OTHERVIRGINIAANTHEM BC/BS
81174812192MEDICAIDVIRGINIA
91174812192OTHERVIRGINIAAETNA
101174812192OTHERVIRGINIAMULTIPLAN
111174812192OTHERVIRGINIACORVEL
121174812192MEDICAIDNORTH CAROLINA
131174812192OTHERVIRGINIAVIRGINIA HEALTH NETWORK
141174812192OTHERVIRGINIACOVENTRY HEALTH CARE
151174812192OTHERVIRGINIACIGNA
161174812192OTHERVIRGINIAHUMANA
171174812192OTHERVIRGINIAUNITED HEALTHCARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.