# CHIPPENHAM AND JOHNSTON-WILLIS SPORTS MEDICINE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1740229608
- **Authorized official:** SUZANNE BERGAMO (VICE PRESIDENT)
- **Authorized official phone:** (804) 267-5950

## Contact information

- **Practice address:** 1115 BOULDERS PKWY STE 110, NORTH CHESTERFIELD, VA 23225-4067
- **Practice address phone:** (804) 560-6500
- **Mailing address:** 2000 HEALTH PARK DR, BRENTWOOD, TN 37027-4692
- **Mailing address phone:** (615) 373-7406

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QS0010X | Sports Medicine (Family Medicine) Physician | — | NULL | Yes |
| 207QS0010X | Sports Medicine (Family Medicine) Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/06/2006
- **Last updated:** 11/20/2025