Individual provider Active NPI

Jessica N. Simmons, M.D.

  • Pediatrics Physician
  • Charlottesville, VA
National Provider Identifier
1083636500
Registry record updated Jul 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
0101239207 Issued in VA
Practice address
400 Brandon Ave
Charlottesville, VA 22903-3310
Phone
(434) 982-3915
Fax
(434) 982-0193
NPI assigned
Jul 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 0101239207 VA Primary

Addresses

Primary practice location

400 Brandon Ave
Charlottesville, VA 22903-3310

Mailing address

1307 St George St
Crozet, VA 22932-3015
Phone (434) 249-3581

Other practice location 1

UVA Augusta Pediatrics
22 North Medical Park Drive
Fishersville, VA 22939
Phone (540) 332-5373

Other identifiers 1

IdentifierTypeStateIssuer
010265118MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101239207VAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Virginia Physicians Group Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593648000000",
    "number": "1083636500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1307 ST GEORGE ST",
            "city": "CROZET",
            "state": "VA",
            "postal_code": "229323015",
            "telephone_number": "434-249-3581",
            "fax_number": "434-972-4266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 BRANDON AVE",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229033310",
            "telephone_number": "434-982-3915",
            "fax_number": "434-982-0193"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "UVA Augusta Pediatrics",
            "address_2": "22 North Medical Park Drive",
            "address_purpose": "LOCATION",
            "city": "Fishersville",
            "state": "VA",
            "postal_code": "22939",
            "country_code": "US",
            "telephone_number": "540-332-5373",
            "fax_number": "540-932-5382",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "JESSICA",
        "middle_name": "N.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-24",
        "last_updated": "2020-07-02",
        "certification_date": "2020-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101239207",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010265118",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.