MEDICARE: BON SECOURS MERCY HEALTH VIRTUAL CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician
2	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1730806118
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BON SECOURS MERCY HEALTH VIRTUAL CARE LLC

Provider Business Mailing Address
First Line	:	4600 MCAULEY PL STE 600
Second Line	:
City	:	BLUE ASH
State	:	OH
Zip	:	45242-4778
Country	:	US
Telephone Number	:	513-752-8000
Fax Number	:

Provider Business Practice Location Address
First Line	:	12320 W BROAD ST STE 204
Second Line	:
City	:	HENRICO
State	:	VA
Zip	:	23233-7603
Country	:	US
Telephone Number	:	513-752-8000
Fax Number	:

Authorized Official
Title or Position	:	SYSTEM DIRECTOR, PAYER DELEGATION &
Name	:	CASSIE LOWE
Credential	:
Telephone Number	:	513-952-5210

Provider Enumeration Date	:	10/26/2022
Last Update Date	:	03/11/2026

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