NPIMap

Individual provider Active NPI

Alison Burkholder Heavenridge, NP

  • Gerontology Nurse Practitioner
  • Charlottesville, VA
National Provider Identifier
1013437854
Registry record updated Aug 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
0024174994 Issued in VA
Practice address
500 Martha Jefferson Dr
Charlottesville, VA 22911
Phone
(434) 654-7580
Fax
(434) 654-7582
NPI assigned
Jun 22, 2017
Last updated
Aug 30, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 0024174994 VA Primary

Addresses

Primary practice location

500 Martha Jefferson Dr
Charlottesville, VA 22911

Mailing address

PO Box 746550
Atlanta, GA 30374-6550
Phone (434) 654-7580

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170911001394 VA Practitioner - Nurse Practitioner 3678475332 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sound Physicians Intensivists of Virginia LLCGroup PAC ID 1759611411, 49 clinicians

Practice addresses (Care Compare)

5801 Bremo Rd
Richmond, VA 23226-1907
Phone (804) 285-2011

8260 Atlee Rd
Mechanicsville, VA 23116-1844
Phone (804) 764-6000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0024174994VAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sound Physicians Intensivists of Virginia LLC CurrentSince Jan 1, 2022 Accepting new patients

Locations

5801 Bremo Rd
Richmond, VA 23226
Phone (804) 281-8220

Organizations & group practices 2

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

Hospital & facility affiliations 8

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": "1498089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1013437854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746550",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746550",
            "telephone_number": "434-654-7580",
            "fax_number": "434-654-7582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 MARTHA JEFFERSON DR",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "22911",
            "telephone_number": "434-654-7580",
            "fax_number": "434-654-7582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEAVENRIDGE",
        "first_name": "ALISON",
        "middle_name": "BURKHOLDER",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-22",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "VA",
            "license": "0024174994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

Verify at the official NPI Registry.