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DOMINION MEDICAL ASSOCIATES INC NPI 1396826046


NPI Information

NPI: 1396826046
Provider Name: DOMINION MEDICAL ASSOCIATES, INC
Classification: Internal Medicine - 207R00000X
Entity Type: Organization

CLIA Number: 49D2049616

Address:
304 E LEIGH ST
RICHMOND, VA
ZIP 23219
Phone: (804) 225-7148
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DOMINION MEDICAL ASSOCIATES, INC is an internal medicine in Richmond, VA. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. DOMINION MEDICAL ASSOCIATES, INC NPI is 1396826046. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

304 E LEIGH ST
RICHMOND, VA
ZIP 23219-410
Phone: (804) 225-7148
Fax: (804) 225-7159

The provider's authorized official is Richard Allen Jackson .
The authorized official title is Presend and has the following contact phone number (804) 225-7148.

The CLIA number assigned to this NPI record is 49D2049616 - community clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/18/2006 and was last updated on 5/30/2008.


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 MedicineNo
2207R00000XInternal MedicineYes

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
1C02365MEDICARE PIN
2=========OTHERVIRGINIATAXES ID #
31396826046OTHERVIRGINIANPI GROUP NUMBER
4C03251MEDICARE PIN

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: 4/28/2024

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.