Alexandra Sledd Mack
Alexandra Sledd · Family Medicine

Address: 825 Fairfax Ave, Ste 118, Norfolk, VA 23507-1914
Phone: 7574465955

Alexandra Sledd Mack (NPI# 1174812192) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider Identifier (NPI) 1174812192
Entity Type Individual
Full Name Alexandra Sledd Mack
Other Name Alexandra Sledd
Credential M.D.
Gender Female
Practice Address 825 Fairfax Ave
Ste 118
Norfolk
VA 23507-1914
Practice Telephone 7574465955
Practice Fax Number 7574465196
Mailing Address Po Box 936
Norfolk
VA 23501-0936
Mailing Telephone 7574465955
Mailing Fax Number 7574465196
Sole Proprietor No, this individual is not a Sole Proprietor
Enumeration Date 2011-03-30
Last Update Date 2017-04-26

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
Yes 207Q00000X Family Medicine Allopathic & Osteopathic Physicians 0101260428 VA

Other Provider Identifier

State Identifier Issuer Type Code
VA 1174812192 OTHER VIRGINIA PREMIER HEALTH PLAN
VA 1174812192 OTHER COVENTRY HEALTH CARE
VA 1174812192 MEDICAID
VA 1174812192 OTHER VIRGINIA HEALTH NETWORK
VA 1174812192 OTHER TRICARE/CHAMPUS
VA 1174812192 OTHER USA MANAGED CARE
VA 1174812192 OTHER OPTIMA HEALTH
VA 1174812192 OTHER AETNA
VA 1174812192 OTHER CIGNA
VA 1174812192 OTHER ANTHEM BC/BS
VA 1174812192 OTHER CORVEL
VA 1174812192 OTHER HUMANA
VA 1174812192 OTHER UNITED HEALTHCARE
VA 1174812192 OTHER MULTIPLAN
NC 1174812192 MEDICAID

Providers with the same name

NPI Name Taxonomy Address Enumeration
1902379498 Alexandra Mack Social Worker 2200 S State St Ste 200, Salt Lake City, UT 84115-2724 2019-01-07
1922592484 Alexandra Mack Speech-Language Pathologist 10 Tinkham Gln, Wilbraham, MA 01095-2427 2018-06-19
1679129399 Alexandra Lea Mack Social Worker 780 American Legion Hwy, Roslindale, MA 02131-3908 2019-08-19
1932648060 Alexandra Mack Behavior Technician 11240 Waples Mill Rd, Fairfax, VA 22030-6078 2017-02-22
1821546904 Alexandra Mack Nurse Practitioner 33100 Cleveland Clinic Blvd, Avon, OH 44011-1390 2016-09-16

Physician Overview

NPI 1174812192
PAC ID by PECOS 0547488157
Professional Enrollment ID I20160822002480
Full Name Alexandra S. Mack
Organization Legal Name EVMS ACADEMIC PHYSICIANS AND SURGEONS HEALTH SERVICES FOUNDATION
Phone Number 7574465955
Gender F
Medical School TULANE UNIVERSITY SCHOOL OF MEDICINE
Graduation Year 2011
Primary Specialty FAMILY MEDICINE
Group Practice PAC ID 5698675510
Number of Group Practice Members 183
Accepts Medicare Assignment Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
490007 SENTARA NORFOLK GENERAL HOSPITAL
490046 SENTARA LEIGH HOSPITAL

Taxonomy Information

Taxonomy Code 207Q00000X
Grouping Allopathic & Osteopathic Physicians
Classification Family Medicine

Taxonomy 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.
Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition]
- Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences.
- Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1144708371 Alison Stover Family Medicine 110 N 29th St Ste 101, Norfolk, NE 68701-4461 2018-07-31
1689169344 Faith Regional Physician Services, LLC Family Medicine 110 N 29th St Ste 201, Norfolk, NE 68701-4461 2018-06-26
1558879346 Sentara Medical Group Family Medicine 301 Riverview Ave Ste 930, Norfolk, VA 23510-1068 2018-01-16
1194243410 Nmg LLC Family Medicine 301 N 27th St Ste 1, Norfolk, NE 68701-4457 2017-09-07
1356864995 Nmg LLC Family Medicine 301 North 27th Street Suite 1, Norfolk, NE 68701 2017-07-25
1063864981 Losika Sivaganeshan Family Medicine 900 W Norfolk Ave Ste 100, Norfolk, NE 68701-5006 2016-07-02
1235506387 Jason Charles Evers Family Medicine 999 Waterside Dr Ste 2525, Norfolk, VA 23510-3316 2015-08-25
1992185011 Marcia Nicole Newby-goodman Family Medicine 930 Majestic Ave Ste 220, Norfolk, VA 23504-4055 2015-06-03
1124438437 Bon Secours Depaul Medical Center Inc Family Medicine 4211 Monarch Way, Norfolk, VA 23508-2540 2014-05-08
1629489935 Joshua Robert Beer Family Medicine 1363 Magnolia Ave, Norfolk, VA 23508-1121 2014-05-08
Find all providers in NORFOLK

Office Location

Street Address 825 FAIRFAX AVE
STE 118
City NORFOLK
State VA
Zip Code 23507-1914

Providers in the same location

NPI Name Taxonomy Address Enumeration
1538167796 Richard Norman Willard Obstetrics & Gynecology 825 Fairfax Ave, Suite 310, Norfolk, VA 23507-1914 2005-07-12
1386240349 Christopher Porter Student in an Organized Health Care Education/Training Program 825 Fairfax Ave, Norfolk, VA 23507-1914 2020-12-07
1831793330 Ian Udsen Student in an Organized Health Care Education/Training Program 825 Fairfax Ave, Norfolk, VA 23507-1428 2020-11-24
1265035166 Rachel Call Student in an Organized Health Care Education/Training Program 825 Fairfax Ave, Norfolk, VA 23507-1914 2020-11-21
1578166468 Courtney Taylor Student in an Organized Health Care Education/Training Program 825 Fairfax Ave, Norfolk, VA 23507-1914 2020-11-21
1730782731 Alexandra Taylor Via Student in an Organized Health Care Education/Training Program 825 Fairfax Ave, Norfolk, VA 23507-1914 2020-11-20
1134722143 Karishma Pankaj Patel Student in an Organized Health Care Education/Training Program 825 Fairfax Ave, Norfolk, VA 23507-1914 2020-11-20
1518560655 Robin Mckay Isdell Student in an Organized Health Care Education/Training Program 825 Fairfax Ave, Norfolk, VA 23507-1914 2020-11-20
1508469149 Laura Elena Ramirez Student in an Organized Health Care Education/Training Program 825 Fairfax Ave, Norfolk, VA 23507-1914 2020-11-17
1740882562 Michelle Janeth Arriola Student in an Organized Health Care Education/Training Program 825 Fairfax Ave, Norfolk, VA 23507-1912 2020-11-16
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1790306801 Paolo Quentin Rigo Student in an Organized Health Care Education/Training Program Smith Rogers Hall, 358 Mowbray Arch, Suite #203/205, Norfolk, VA 23507 2020-04-29
1811526221 Sean M Whitty Student in an Organized Health Care Education/Training Program Emergency Medicine Residency, Raleigh Building, St 304, 600 Gresham Dr, Norfolk, VA 23507 2020-04-07
1962030643 Shekinah Joy Vaughn Student in an Organized Health Care Education/Training Program 385 Mowbray Arch Ste 203205, Norfolk, VA 23507 2020-03-30
1982231403 Jaxon Vallely Student in an Organized Health Care Education/Training Program 358 Mowbray Arch, Suite #203/205, Norfolk, VA 23507 2020-03-25
1437714656 Kanishk Deep Sharma Student in an Organized Health Care Education/Training Program 825 Fairfax Avenue Eastern Virginia Medical School Inte, Suite 445, Norfolk, VA 23507 2019-05-02
1619439460 Dylan Woolum Student in an Organized Health Care Education/Training Program Raleigh Building, Suite 304, 600 Gresham Drive, Norfolk, VA 23507 2019-04-02
1477012623 Jessie R Jones Student in an Organized Health Care Education/Training Program 825 Fairfax Ave Ste 513a, Norfolk, VA 23507 2019-03-18
1316416787 Lindsey Sawyer Genetic Counselor, MS Childrens Hospital of The Kings Daughters, 601 Childrens Lane, Norfolk, VA 23507 2018-11-15
1881188159 Patrick Michael Haar Pharmacist 601 Pembroke Avenue, Apt 104, Norfolk, VA 23507 2018-06-19
1316438377 Monika Pajhal Student in an Organized Health Care Education/Training Program Eastern Virginia Medical School (internal Medicine), Internal Medicine, 825 Fairfax Ave, Suite 410, Norfolk, VA 23507 2018-05-25
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Competitor

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City NORFOLK
Zip Code 23507

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.