VCU SPORTS MEDICINE-VCU SPORTS MEDICINE
NPI 1336367630
Clinic/Center in Richmond, VA

Active since April 23, 2007CLIA 49D2306954 · Waiver
1300 W BROAD ST, RICHMOND, VA 23284(804) 828-6315 Get Directions Write a Review

NPPES record last updated: December 31, 2010. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Vcu Sports Medicine-vcu Sports Medicine NPPES

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

VCU SPORTS MEDICINE-VCU SPORTS MEDICINE (NPI 1336367630) is a healthcare organization registered as a clinic/center in Richmond, Virginia and active in the NPI registry since April 2007. The organization holds a CLIA Waiver certificate valid through June 26, 2028 and lists Dominic J Puleo, Cfo, as its authorized official.

NPPES Registry Identity

NPI1336367630
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameVIRGINIA COMMONWEALTH UNIVERSITY HEALTH SYSTEM
Location Address1300 W BROAD STRichmond, VA 23284-9089
Mailing AddressPo Box 758997Baltimore, MD 21275-0001
Organization SubpartNo
Authorized OfficialDominic J PuleoCfo · (804) 828-1295
Enumeration DateApril 23, 2007
Last NPPES UpdateDecember 31, 2010
NPI 1336367630 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
License Licensed in VA · H1875
Definition

A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

1300 W BROAD ST, Richmond, VA 23284

Other Names 1

Doing Business AsVcu Sports Medicine-vcu Sports Medicine

Other Identifiers 2

Other442277VA · Anthem-vcu Sports Medicine
Other180914VA · Anthem

CLIA Laboratory Certificates CMS CLIA

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 49D2306954

Vcu Sports Medicine Clinic · Richmond, VA
Active · expires Jun 26, 2028
CLIA Number49D2306954
Laboratory TypeCommunity Clinic
Certificate Effective DateJune 27, 2026
Certificate Expiration DateJune 26, 2028
Laboratory DirectorAlden E. Chesney
Laboratory Phone(804) 828-0822
Laboratory LocationVcu Sports Medicine Clinic1300 W Broad St #113, Richmond, VA 23284
CLIA data matches this NPI record on: Address
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 19

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

Nurse Practitioner
1300 W BROAD ST, VCU STUDENT HEALTH SERVICES
RICHMOND, VA 23284
Specialist/Technologist (Athletic Trainer)
1300 W BROAD ST
RICHMOND, VA 23284
Nurse Practitioner (Family)
1300 W BROAD ST
RICHMOND, VA 23284
Nurse Practitioner (Women's Health)
1300 W BROAD ST
RICHMOND, VA 23284
Internal Medicine
1300 W BROAD ST, SUITE 2200
RICHMOND, VA 23284
Specialist/Technologist (Athletic Trainer)
1300 W BROAD ST
RICHMOND, VA 23284
Nurse Practitioner
1300 W BROAD ST, SUITE 2200
RICHMOND, VA 23284
Specialist/Technologist (Athletic Trainer)
1300 W BROAD ST, SUITE 130A
RICHMOND, VA 23284

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 Virginia Commonwealth University Health System's NPI number?

The NPI number for Virginia Commonwealth University Health System is 1336367630. It was assigned to this organization in the NPPES registry on April 23, 2007. The provider is doing business as Vcu Sports Medicine-Vcu Sports Medicine.

Where is Virginia Commonwealth University Health System located?

Virginia Commonwealth University Health System is located at 1300 W Broad St, Richmond, VA 23284. The listed phone number is (804) 828-6315.

What is Virginia Commonwealth University Health System's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Does Virginia Commonwealth University Health System hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 49D2306954) is associated with this NPI, valid through June 26, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Virginia Commonwealth University Health System was last updated on December 31, 2010. NPI Profile syncs with the weekly NPPES data releases published by CMS.