1760489363 NPI number — DR. IGNACIO RIPOLL M.D.

Table of content: DR. IGNACIO RIPOLL M.D. (NPI 1760489363)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760489363 NPI number — DR. IGNACIO RIPOLL M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RIPOLL
Provider First Name:
IGNACIO
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1760489363
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/24/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3241 WESTERN BRANCH BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHESAPEAKE
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23321-5260
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
757-686-3508
Provider Business Mailing Address Fax Number:
757-686-0541

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6025 PROVIDENCE RD
Provider Second Line Business Practice Location Address:
STE 110
Provider Business Practice Location Address City Name:
VIRGINIA BEACH
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23464-3808
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-474-7447
Provider Business Practice Location Address Fax Number:
757-474-7477
Provider Enumeration Date:
06/28/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  0101026535 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0004004821 . This is a "AETNA US HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 48-00018 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 911940000 . This is a "MEDICAID OF FLORIDA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 541910047 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 790518Q , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 005818800 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 110179234 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 325173 . This is a "ANTHEM BC/BS" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 603296 . This is a "BC/BS OF PENNSYLVANIA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 361931 . This is a "MAMSI/MDIPA/OPITMUM CHOIC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 541910047 . This is a "VA HEALTH NETWORK" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 290358 . This is a "PHCS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0770109 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 15246 . This is a "SENTARA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 541910047 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: XPY081400 . This is a "EDS MEDI-CAL" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: P12004433 . This is a "MULTIPLAN" identifier . This identifiers is of the category "OTHER".




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