NPIMap

Individual provider Active NPI

Jonathan L Siddon, D.O.

  • Internal Medicine Physician
  • Gainesville, VA
National Provider Identifier
1003194218
Registry record updated Apr 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0102203729 Issued in VA
Practice address
7051 Heathcote Village Way Ste 140
Gainesville, VA 20155-3198
Phone
(571) 685-4388
Fax
(703) 743-5275
NPI assigned
Jul 22, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0102203729 VA Primary

Addresses

Primary practice location

7051 Heathcote Village Way Ste 140
Gainesville, VA 20155-3198

Mailing address

7051 Heathcote Village Way Ste 140
Gainesville, VA 20155-3198
Phone (571) 685-4388

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140722000930 DC Practitioner - Internal Medicine 1759512858 Reassigns benefits to 1 organization
I20140729000247 VA Practitioner - Internal Medicine 1759512858 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Privia Medical Group, LLCGroup PAC ID 4385682061, 1,522 clinicians
Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians

Practice addresses (Care Compare)

8644 Sudley Rd
Suite 220
Manassas, VA 20110-4425
Phone (571) 366-8845

950 N Glebe Rd
Suite 700
Arlington, VA 22203-4173

9642 Burke Lake Rd
Burke, VA 22015-3052
Phone (703) 543-7920

Hospital & facility affiliations

  • Five Star Home Health Care Home health agency, Chantilly, VA, CCN 497678
  • Uva Health Haymarket Medical Center Hospital, Haymarket, VA, CCN 490144
  • Inova Fairfax Hospital Hospital, Falls Church, VA, CCN 490063
  • Uva Health Prince William Medical Center Hospital, Manassas, VA, CCN 490045
  • Fauquier Hospital Hospital, Warrenton, VA, CCN 490023
  • Inova Fair Oaks Hospital Hospital, Fairfax, VA, CCN 490101

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
0102203729VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC Internal Medicine CurrentSince Mar 9, 2019 Accepting new patients
Privia Medical Group, LLC CurrentSince Mar 9, 2019 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Nova Physician Wellness Center PLLC Past Accepting new patients

Locations

9470 Annapolis Rd
Ste 309
Lanham, MD 20706
Phone (202) 832-1800

8109 Hinson Farm Rd
Ste 504
Alexandria, VA 22306
Phone (703) 339-3210

7051 Heathcote Village Way
Ste 140
Gainesville, VA 20155
Phone (571) 685-4388

8988 Lorton Station Blvd
Ste 100
Lorton, VA 22079
Phone (703) 339-3210

7764 Armistead Rd
Ste 240
Lorton, VA 22079
Phone (571) 359-4000

8644 Sudley Rd
#220
Manassas, VA 20110

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
  • Direct secure messaging: jonathan.siddon.2@8042.direct.athenahealth.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1311292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618185600000",
    "number": "1003194218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7051 HEATHCOTE VILLAGE WAY STE 140",
            "city": "GAINESVILLE",
            "state": "VA",
            "postal_code": "201553198",
            "telephone_number": "571-685-4388",
            "fax_number": "703-743-5275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7051 HEATHCOTE VILLAGE WAY STE 140",
            "city": "GAINESVILLE",
            "state": "VA",
            "postal_code": "201553198",
            "telephone_number": "571-685-4388",
            "fax_number": "703-743-5275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDON",
        "first_name": "JONATHAN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-22",
        "last_updated": "2021-04-12",
        "certification_date": "2021-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0102203729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, VA

Sources for this page

Verify at the official NPI Registry.