NPIMap

Individual provider Active NPI

Cameron Simmons, PA-C

  • Physician Assistant
  • Charlottesville, VA
National Provider Identifier
1073014692
Registry record updated Dec 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110006037 Issued in VA
Practice address
3025 Berkmar Dr
Charlottesville, VA 22901-1456
Phone
(434) 973-1831
NPI assigned
Feb 28, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110006037 VA Primary

Addresses

Primary practice location

3025 Berkmar Dr
Charlottesville, VA 22901-1456

Mailing address

303 B 2ND St. NW
Charlottesville, VA 22902
Phone (804) 363-9049

Other practice location 1

7200 Glen Forest Dr Ste 106
Richmond, VA 23226-3768
Phone (804) 495-0053

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
I20180614000320 VA Practitioner - Physician Assistant 7517212665 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Barry University School of Podiatric Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bon Secours Medical Group Richmond Primary Care LLCGroup PAC ID 3476986613, 91 clinicians

Practice addresses (Care Compare)

1362 Tappahannock Blvd
Tappahannock, VA 22560-9309
Phone (804) 443-5378

306 Ashcake Rd
Suite C
Ashland, VA 23005-2323
Phone (804) 798-9208

Hospital & facility affiliations

  • At Home Care Home health agency, Mechanicsvlle, VA, CCN 497493
  • James River Home Health Agency Home health agency, Richmond, VA, CCN 497706
  • Bon Secours St Marys Hospital Hospital, Richmond, VA, CCN 490059
  • Bon Secours Memorial Regional Medical Center Hospital, Mechanicsville, VA, CCN 490069
  • Bon Secours Richmond Community Hospital Hospital, Richmond, VA, CCN 490094
  • Henrico Doctors' Hospital Hospital, Richmond, VA, CCN 490118

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0110006037VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC CurrentSince Mar 16, 2018 Accepting new patients
Privia Medical Group, LLC CurrentSince Mar 16, 2018 Accepting new patients
Commonwealth Counseling Associates Inc Past Accepting new patients

Locations

3025 Berkmar Dr
Charlottesvle, VA 22901
Phone (434) 973-1831

3025 Berkmar Dr
Ste 1
Charlottesvle, VA 22901
Phone (434) 973-1831

8644 Sudley Rd
#220
Manassas, VA 20110

Interoperability endpoints

  • Direct secure messaging: csimmons1155763@direct.bsmhealth.org

Organizations & group practices 5

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 11

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": "1519776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608768000000",
    "number": "1073014692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 B 2ND ST. NW",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "22902",
            "telephone_number": "804-363-9049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3025 BERKMAR DR",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229011456",
            "telephone_number": "434-973-1831"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7200 Glen Forest Dr Ste 106",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232263768",
            "country_code": "US",
            "telephone_number": "804-495-0053",
            "fax_number": "720-598-0440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "CAMERON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-28",
        "last_updated": "2020-12-24",
        "certification_date": "2020-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110006037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

Verify at the official NPI Registry.