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GLEN ALLEN INTERNAL MEDICINE
NPI 1063799302
Internal Medicine in Glen Allen, VA

Active since November 15, 2011
5207 HICKORY PARK DR, SUITE A, GLEN ALLEN, VA 23059(804) 612-2980(804) 762-7102 Get Directions Write a Review

NPPES record last updated: October 24, 2018. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Glen Allen Internal Medicine NPPES

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

GLEN ALLEN INTERNAL MEDICINE (NPI 1063799302) is a healthcare organization registered as an internal medicine in Glen Allen, Virginia and active in the NPI registry since November 2011. The organization lists George O Butler, Director Corporate Responsibility, as its authorized official.

NPPES Registry Identity

NPI1063799302
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameBON SECOURS-ST. MARY'S HOSPITAL OF RICHMOND, INC.
Location Address5207 HICKORY PARK DR, SUITE AGlen Allen, VA 23059-2624
Mailing Address5207 Hickory Park Dr, Suite AGlen Allen, VA 23059-2624 · (804) 612-2980 · Fax (804) 762-7102
Phone(804) 612-2980
Fax(804) 762-7102
Organization SubpartNo
Authorized OfficialGeorge O ButlerDirector Corporate Responsibility · (804) 281-0271
Enumeration DateNovember 15, 2011
Last NPPES UpdateOctober 24, 2018
✔ NPI 1063799302 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
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.
5207 HICKORY PARK DR, Glen Allen, VA 23059
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Other Names 1

Doing Business AsGlen Allen Internal Medicine

Other Identifiers 1

OtherC06778VA · Group Ptan

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Glen Allen Internal Medicine is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

163

Medicare enrollment records show 163 clinicians reassign Medicare billing to Glen Allen Internal Medicine, which bills Medicare for the services they deliver. Of these, 68 practice within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 24

Nurse Practitioner46
Internal Medicine25
Obstetrics/Gynecology23
Family Practice16
Cardiovascular Disease (Cardiology)15
Hospice/Palliative Care6
Interventional Cardiology4
General Surgery3
16 other specialties25

Nearest to this location (20)

See all 163
Pravin Deshmukh, M.D.
Internal Medicine
NPI 1073511200
12320 W BROAD ST STE 204
Richmond, VA 23233
(804) 612-2980
✔ PECOS✔ Accepts Medicare3.1 mi
Kathryn Johnston, FNP-BC
Nurse Practitioner
NPI 1316295694
2300 CEDARFIELD PKWY
Richmond, VA 23233
(804) 474-8870
✔ PECOS✔ Accepts Medicare3.2 mi
Emily Slater, NP
Nurse Practitioner
NPI 1023471034
10150 STAPLES MILL RD SUITE A
Glen Allen, VA 23060
(804) 893-8627
✔ PECOS3.9 mi
Mark Barr, M.D.
Family Practice
NPI 1962473371
9600 PATTERSON AVE
Richmond, VA 23229
(804) 741-6200
✔ PECOS5.5 mi
Samantha Bishop, NP-BC
Nurse Practitioner
NPI 1770255408
9600 PATTERSON AVE
Richmond, VA 23229
(804) 741-6200
✔ PECOS5.5 mi
Haroon Hyder, M.D.
Family Practice
NPI 1740470483
9600 PATTERSON AVE
Richmond, VA 23229
(804) 741-6200
✔ PECOS✔ Accepts Medicare5.5 mi
Robin Disler, MD
Internal Medicine
NPI 1366404493
7001 FOREST AVE SUITE 2500
Richmond, VA 23230
(804) 282-7857
✔ PECOS6.2 mi
Massimo Giusti, MD
Cardiovascular Disease (Cardiology)
NPI 1720011398
7001 FOREST AVE SUITE 200
Richmond, VA 23230
(804) 288-3123
✔ PECOS✔ Accepts Medicare6.2 mi
Matthew Ngo, MD.
Cardiac Electrophysiology
NPI 1912060609
7001 FOREST AVE SUITE 200
Richmond, VA 23230
(804) 288-3123
✔ PECOS✔ Accepts Medicare6.2 mi
John Unkel, DDS
Oral Surgery
NPI 1750316618
6900 FOREST AVE SUITE 110
Richmond, VA 23230
(804) 893-8715
✔ PECOS6.2 mi
Mary Ransom, MD
Neurology
NPI 1487697389
5855 BREMO RD SUITE 207
Richmond, VA 23226
(804) 893-8656
✔ PECOS✔ Accepts Medicare7.7 mi
Sihong Suy, MD
General Surgery
NPI 1750588125
5855 BREMO RD SUITE 506
Richmond, VA 23226
(804) 285-3225
✔ PECOS✔ Accepts Medicare7.7 mi
Cara Jennings, MD
Physical Medicine and Rehabilitation
NPI 1174783716
5855 BREMO RD SUITE 509
Richmond, VA 23226
(804) 288-2673
✔ PECOS✔ Accepts Medicare7.7 mi
Mary Lucchesi, M.D.
Hospice/Palliative Care
NPI 1134353220
5855 BREMO RD SUITE 207
Richmond, VA 23226
(804) 288-3079
✔ PECOS✔ Accepts Medicare7.7 mi
Matthew Austin, MD
Diagnostic Radiology
NPI 1447463658
5801 BREMO RD STE 208
Richmond, VA 23226
(804) 287-3500
✔ PECOS✔ Accepts Medicare7.7 mi
Mark Bladergroen, M.D.
Cardiac Surgery
NPI 1124058342
5875 BREMO RD SUITE G-5
Richmond, VA 23226
(804) 287-7840
✔ PECOS✔ Accepts Medicare7.7 mi
Elna Kochummen, M.D
Endocrinology
NPI 1710147988
5875 BREMO RD
Richmond, VA 23226
(804) 287-7322
✔ PECOS7.7 mi
Paul Wehman, M.D.
Thoracic Surgery
NPI 1639483209
5875 BREMO RD STE 400B
Richmond, VA 23226
(804) 287-7840
✔ PECOS✔ Accepts Medicare7.7 mi
Alice Hirata, M.D.
Obstetrics/Gynecology
NPI 1760466684
5875 BREMO RD SUITE 400
Richmond, VA 23226
(804) 288-4084
✔ PECOS7.7 mi
Carl Rountree, MD
Pediatric Medicine
NPI 1821291303
5875 BREMO RD SUITE 303
Richmond, VA 23226
(804) 893-8610
✔ PECOS✔ Accepts Medicare7.7 mi
See all 163 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Bon Secours-St. Mary's Hospital Of Richmond, Inc.'s NPI number?

The NPI number for Bon Secours-St. Mary's Hospital Of Richmond, Inc. is 1063799302. It was assigned to this organization in the NPPES registry on November 15, 2011. The provider is doing business as Glen Allen Internal Medicine.

Where is Bon Secours-St. Mary's Hospital Of Richmond, Inc. located?

Bon Secours-St. Mary's Hospital Of Richmond, Inc. is located at 5207 Hickory Park Dr Suite A, Glen Allen, VA 23059. The listed phone number is (804) 612-2980.

What is Bon Secours-St. Mary's Hospital Of Richmond, Inc.'s specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Bon Secours-St. Mary's Hospital Of Richmond, Inc. enrolled in Medicare?

Yes. Bon Secours-St. Mary's Hospital Of Richmond, Inc. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Bon Secours-St. Mary's Hospital Of Richmond, Inc.?

According to the CMS Revalidation Reassignment List (October 2026 release), 163 clinicians in 24 Medicare specialties reassign their Medicare billing to Bon Secours-St. Mary's Hospital Of Richmond, Inc.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (46), Internal Medicine (25) and Obstetrics/Gynecology (23). Of these, 68 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Bon Secours-St. Mary's Hospital Of Richmond, Inc. was last updated on October 24, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.