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SENTARA FAMILY & INTERNAL MEDICINE PHYSICIANS
NPI 1043592462
Family Medicine in Lake Ridge, VA

Active since September 12, 2011CLIA Certified · 2 labs
12825 MINNIEVILLE RD, STE 202, LAKE RIDGE, VA 22192(571) 542-4950(571) 285-1160 Get Directions Write a Review

NPPES record last updated: March 28, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Sentara Family & Internal Medicine Physicians NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SENTARA FAMILY & INTERNAL MEDICINE PHYSICIANS (NPI 1043592462) is a healthcare organization registered as a family medicine in Lake Ridge, Virginia and active in the NPI registry since September 2011. The organization holds 2 active CLIA laboratory certificates and lists Cindy A Taylor, Manager, as its authorized official.

NPPES Registry Identity

NPI1043592462
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameSENTARA MEDICAL GROUP
Location Address12825 MINNIEVILLE RD, STE 202Lake Ridge, VA 22192-3601
Mailing Address12825 Minnieville Rd, Ste 202Lake Ridge, VA 22192-3601 · (571) 542-4950 · Fax (571) 285-1160
Phone(571) 542-4950
Fax(571) 285-1160
Organization SubpartNo
Authorized OfficialCindy A TaylorManager · (757) 252-2765
Enumeration DateSeptember 12, 2011
Last NPPES UpdateMarch 28, 2017
✔ NPI 1043592462 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
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.
Also ListedInternal MedicineTaxonomy 207R00000X
Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
12825 MINNIEVILLE RD, Lake Ridge, VA 22192
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Other Names 1

Doing Business AsSentara Family & Internal Medicine Physicians

Other Identifiers 1

OtherC02033VA · Medicare Group Number

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 49D1018980

Sentara Family & Internal Medicine Physicians - Woodbridge · Woodbridge, VA
Active · expires Nov 5, 2027
CLIA Number49D1018980
Laboratory TypePhysician Office
Certificate Effective DateNovember 6, 2025
Certificate Expiration DateNovember 5, 2027
Laboratory DirectorRaenell C. Williams
Laboratory Phone(571) 542-4955
Laboratory LocationSentara Family & Internal Medicine Physicians - Woodbridge4500 Pond Way, Suite 170, Woodbridge, VA 22192
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 49D2330921

Sentara Family & Internal Medicine Physicians - Old Bridge · Lake Ridge, VA
Active · expires Sep 23, 2027
CLIA Number49D2330921
Laboratory TypePhysician Office
Certificate Effective DateSeptember 24, 2025
Certificate Expiration DateSeptember 23, 2027
Laboratory DirectorDr. Ilesh Patel
Laboratory Phone(540) 779-5180
Laboratory LocationSentara Family & Internal Medicine Physicians - Old Bridge3401 Commission Court, Suite 201, Lake Ridge, VA 22192
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MEDSTAR MEDICAL GROUP II LLC
General Practice
12825 MINNIEVILLE RD
WOODBRIDGE, VA 22192
Prince William County (703) 971-3701
MEDSTAR MEDICAL GROUP II LLC
General Practice
12825 MINNIEVILLE RD, STE 203
WOODBRIDGE, VA 22192
Prince William County (703) 971-3701
MISS LILLY MAIRE ORTEGA TORRES EMT
Emergency Medical Technician, Basic
12825 MINNIEVILLE RD
LAKE RIDGE, VA 22192
Prince William County (703) 523-9800
LESLIANNE GRENDYSZ LNP
Nurse Practitioner (Family)
12825 MINNIEVILLE RD, SUITE 202
LAKE RIDGE, VA 22192
Prince William County (703) 780-2800
SENTARA MEDICAL GROUP
Family Medicine
12825 MINNIEVILLE RD, STE 202
LAKE RIDGE, VA 22192
Prince William County (703) 780-2800
GILISSA JOHNSON
Physical Therapist
12825 MINNIEVILLE RD
LAKE RIDGE, VA 22192
Prince William County (703) 971-3701
DR. DANIEL MARK HAMPTON MD
Orthopaedic Surgery (Sports Medicine)
12825 MINNIEVILLE RD, SUITE 203
WOODBRIDGE, VA 22192
Prince William County (301) 856-1682
ASHLEY NORMAN PT, DPT
Physical Therapist
12825 MINNIEVILLE RD, SUITE 201
LAKE RIDGE, VA 22192
Prince William County (855) 546-0939

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sentara Medical Group's NPI number?

The NPI number for Sentara Medical Group is 1043592462. It was assigned to this organization in the NPPES registry on September 12, 2011. The provider is doing business as Sentara Family & Internal Medicine Physicians.

Where is Sentara Medical Group located?

Sentara Medical Group is located at 12825 Minnieville Rd Ste 202, Lake Ridge, VA 22192. The listed phone number is (571) 542-4950.

What is Sentara Medical Group's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Sentara Medical Group hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Sentara Medical Group was last updated on March 28, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.