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BLUESTONE PHYSICIAN SERVICES SOUTHEAST LLC
NPI 1255945739
Family Medicine in Norfolk, VA

Active since September 02, 2020CLIA Certified · 3 labs
999 WATERSIDE DR STE 2525, NORFOLK, VA 23510(757) 777-3433(855) 818-3907 Get Directions Write a Review

NPPES record last updated: October 22, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 22, 2020, Sep 2, 2020 (2 updates tracked since 2020).

About Bluestone Physician Services Southeast Llc NPPES

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

BLUESTONE PHYSICIAN SERVICES SOUTHEAST LLC (NPI 1255945739), doing business as Bluestone Physician Services Florida, Llc, is a healthcare organization registered as a family medicine in Norfolk, Virginia and active in the NPI registry since September 2020. The organization holds 3 active CLIA laboratory certificates and lists Tim Koehler, Coo, as its authorized official.

NPPES Registry Identity

NPI1255945739
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameBLUESTONE PHYSICIAN SERVICES SOUTHEAST LLC
Location Address999 WATERSIDE DR STE 2525Norfolk, VA 23510-3316
Mailing Address270 Main St N Ste 300Stillwater, MN 55082-6788 · (651) 342-1039 · Fax (651) 342-1428
Phone(757) 777-3433
Fax(855) 818-3907
Organization SubpartNo
Authorized OfficialTim KoehlerCoo · (651) 342-1039
Enumeration DateSeptember 2, 2020
Last NPPES UpdateOctober 22, 20202 updates tracked since enumeration
NPPES CertifiedOctober 22, 2020
✔ NPI 1255945739 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ 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 ListedGeneral PracticeTaxonomy 208D00000X
999 WATERSIDE DR STE 2525, Norfolk, VA 23510
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Other Names 1

Former Legal Business NameBluestone Physician Services Florida, Llc

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

CLIA Laboratory Certificates CMS CLIA 3

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 10D2211041

Bluestone Physician Services Southeast LLC · Tampa, FL
Active · expires Jan 25, 2027
CLIA Number10D2211041
Laboratory TypeMobile Pcp
Certificate Effective DateJanuary 26, 2025
Certificate Expiration DateJanuary 25, 2027
Laboratory DirectorSarah Keenan
Laboratory Phone(651) 342-1039
Laboratory LocationBluestone Physician Services Southeast LLC10150 Highland Manor Dr, Suite 240, Tampa, FL 33610
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 24D2082638

Bluestone Physician Services, PA · Stillwater, MN
Active · expires Oct 19, 2026
CLIA Number24D2082638
Laboratory TypeMobile Primary Care Pract
Certificate Effective DateOctober 20, 2024
Certificate Expiration DateOctober 19, 2026
Laboratory DirectorRajiv Patel
Laboratory Phone(651) 342-1039
Laboratory LocationBluestone Physician Services, PA270 North Main St, Ste 300, Stillwater, MN 55082
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 52D2195082

Bluestone Physician Services Wisconsin, Sc · Milwaukee, WI
Active · expires Oct 5, 2026
CLIA Number52D2195082
Laboratory TypePractitioner Other
Certificate Effective DateOctober 6, 2024
Certificate Expiration DateOctober 5, 2026
Laboratory DirectorDr. Rajiv N. Patel
Laboratory Phone(651) 342-1039
Laboratory LocationBluestone Physician Services Wisconsin, Sc342 N Water Street, Suite 600, Milwaukee, WI 53202
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

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

MRS. DARNETTA RECITIA ARMISTEAD LCSW-S
Social Worker (Clinical)
999 WATERSIDE DR STE 2525
NORFOLK, VA 23510
Norfolk City (267) 530-8010
APPENDIX INC
Counselor (Mental Health)
999 WATERSIDE DR STE 2525
NORFOLK, VA 23510
Norfolk City (757) 664-9402
HART TO HEALING THERAPY & CONSULTANT SERVICES PLLC
Counselor (Mental Health)
999 WATERSIDE DR STE 2525
NORFOLK, VA 23510
Norfolk City (757) 271-3646
SPIRIT ABA VA LLC
Behavior Analyst
999 WATERSIDE DR STE 2525
NORFOLK, VA 23510
Norfolk City (732) 267-4591
LIFEPHYSICIAN, LLC
Clinic/Center (Primary Care)
999 WATERSIDE DR STE 2525
NORFOLK, VA 23510
Norfolk City (925) 824-3198
SHARON WRIGHT MBA
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
999 WATERSIDE DR STE 2525
NORFOLK, VA 23510
Norfolk City (917) 589-8679
OWNA THERAPEUTIC SERVICES LLC
Community/Behavioral Health
999 WATERSIDE DR STE 2525
NORFOLK, VA 23510
Norfolk City (757) 304-8801
TRICOASTAL PSYCHOLOGICAL SERVICES, LLC
Psychologist (Clinical)
999 WATERSIDE DR STE 2525
NORFOLK, VA 23510
Norfolk City (757) 204-5701

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 Bluestone Physician Services Southeast LLC's NPI number?

The NPI number for Bluestone Physician Services Southeast LLC is 1255945739. It was assigned to this organization in the NPPES registry on September 2, 2020. The provider was formerly known as Bluestone Physician Services Florida, LLC.

Where is Bluestone Physician Services Southeast LLC located?

Bluestone Physician Services Southeast LLC is located at 999 Waterside Dr Ste 2525, Norfolk, VA 23510. The listed phone number is (757) 777-3433.

What is Bluestone Physician Services Southeast LLC's specialty?

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

Does Bluestone Physician Services Southeast LLC hold CLIA laboratory certificates?

Yes. 3 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 Bluestone Physician Services Southeast LLC was last updated on October 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.