Healthcare Provider Details

I. General information

NPI: 1407157647
Provider Name (Legal Business Name): JAMES RIVER CARDIOLOGY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2010
Last Update Date: 08/11/2025
Certification Date: 08/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

445 CHARLES H DIMMOCK PKWY STE 100
COLONIAL HEIGHTS VA
23834-2990
US

IV. Provider business mailing address

445 CHARLES DIMMOCK PARKWAY SUITE 100
COLONIAL HEIGHTS VA
23834
US

V. Phone/Fax

Practice location:
  • Phone: 804-520-1764
  • Fax: 866-781-3220
Mailing address:
  • Phone: 804-520-1764
  • Fax: 866-781-3220

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number0101241485
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: MITESH S AMIN
Title or Position: CARDIOLOGIST
Credential: M.D.
Phone: 804-400-1322