NPIMap

Individual provider Active NPI

Henry Clay Surber, PA-C

  • Medical Physician Assistant
  • Zion Crossroads, VA
National Provider Identifier
1093104945
Registry record updated Aug 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
0110-004782 Issued in VA
Practice address
1015 Spring Creek Pkwy
Zion Crossroads, VA 22942-7019
Phone
(434) 243-9466
NPI assigned
Jan 15, 2015
Last updated
Aug 26, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 001005491 NC
Medical Physician Assistant 363AM0700X 0110-004782 VA Primary

Addresses

Primary practice location

1015 Spring Creek Pkwy
Zion Crossroads, VA 22942-7019

Mailing address

PO Box 9007
Charlottesville, VA 22906-9007

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
I20210824000916 VA Practitioner - Physician Assistant 9436479227 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Commonwealth Primary CareGroup PAC ID 2264420918, 65 clinicians

Practice addresses (Care Compare)

1800 Glenside Dr
Richmond, VA 23226-3769

7140 Hull St Rd
Suite 101
Richmond, VA 23235-5802
Phone (804) 276-4141

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
001005491NCMDMedical Physician Assistant
0110-004782VAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Virginia Physicians Group CurrentSince Aug 23, 2021 Accepting new patients
Commonwealth Primary Care CurrentSince Jun 21, 2023 Accepting new patients
Commonwealth Primary Care Past Accepting new patients

Locations

1215 Lee St
Fl 8
Charlottesvle, VA 22908
Phone (434) 924-2500

7140 Hull Street Rd
Ste 101
North Chesterfield, VA 23235
Phone (804) 276-4141

1800 Glenside Dr
Ste 105
Richmond, VA 23226
Phone (804) 288-0399

1015 Spring Creek Pkwy
Zion Crossroads, VA 22942
Phone (434) 243-9136

Interoperability endpoints

  • Direct secure messaging: henry.surber@cpcva.eclinicaldirectplus.com

Organizations & group practices 3

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 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1421280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629936000000",
    "number": "1093104945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9007",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229069007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 SPRING CREEK PKWY",
            "city": "ZION CROSSROADS",
            "state": "VA",
            "postal_code": "229427019",
            "telephone_number": "434-243-9466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SURBER",
        "first_name": "HENRY",
        "middle_name": "CLAY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-01-15",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "001005491",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110-004782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Zion Crossroads, VA

Sources for this page

Verify at the official NPI Registry.