Provider Demographics
NPI:1447447925
Name:COMPASS MD
Entity type:Organization
Organization Name:COMPASS MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:W
Authorized Official - Last Name:VERHEUL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:804-423-9926
Mailing Address - Street 1:13911 ST FRANCIS BLVD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23114-3256
Mailing Address - Country:US
Mailing Address - Phone:804-423-9926
Mailing Address - Fax:804-423-9926
Practice Address - Street 1:13911 ST FRANCIS BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23114-3256
Practice Address - Country:US
Practice Address - Phone:804-423-9926
Practice Address - Fax:804-423-9926
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-28
Last Update Date:2007-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101039982174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA051223OtherANTHEM BCBS
VAB09692Medicare UPIN