Thresa Helen Simon, M.D.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

0101840405 Issued in VA

Practice address

269 Medical Park Blvd
Petersburg, VA 23805-9337

Phone

(804) 861-0700

Fax

(804) 863-4626

NPI assigned

Apr 20, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Other, 1988

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Virginia South Psychiatric and Family ServicesGroup PAC ID 3476443797, 35 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• KY PPO C-SNP
• TN PPO C-SNP
• TN PPO
• KY PPO
• devoted network organization-92131eb0-09f2-4173-a140-cf7b381f0cf1

Interoperability endpoints

• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.72142

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.

• Virginia South Psychiatric & Family Services

  • Psychiatry Physician
  • Petersburg, VA
  • NPI 1700894466
  Medicare reassignment Care Compare group NPD
• District 19 Community Services Board

  • Community/Behavioral Health Agency
  • Petersburg, VA
  • NPI 1225094451
  NPD (past)
• Three Rivers Treatment Center LLC

  • Psychiatric Residential Treatment Facility
  • Kenbridge, VA
  • NPI 1568827780
  NPD (past)

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

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380672000000",
    "number": "1003871989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "269 MEDICAL PARK BLVD",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238059337",
            "telephone_number": "804-861-0700",
            "fax_number": "804-863-4626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "269 MEDICAL PARK BLVD",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238059337",
            "telephone_number": "804-861-0700",
            "fax_number": "804-863-4626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "THRESA",
        "middle_name": "HELEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-20",
        "last_updated": "2013-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0101840405",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "VA",
            "license": "0101840405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brad Thomas Siegmund, MD
• Joseph W Siko Jr., DPM
• Silvers Surgical Associates LLC
• Kenneth Silvers, CSA
• Iana Jenniek Simmons
• Kelsey Anyla Singh
• SJW Behavioral Health Network
• SKB Services LLC
• James Lester Slagle Jr., DDS
• Kara Michelle Sloan

• Child & Adolescent Psychiatry Physician in Petersburg, VA
• Providers in Petersburg, VA by specialty
• Child & Adolescent Psychiatry Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.