Individual provider Active NPI

Jessica Kent Erim

  • Physician Assistant
  • Leesburg, VA
National Provider Identifier
1093479339
Registry record updated Mar 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110008446 Issued in VA
Practice address
19450 Deerfield Avenue, Suite 300
Leesburg, VA 20176-2681
Phone
(703) 858-3220
Fax
(703) 858-3221
NPI assigned
Oct 22, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X 0110008446 VA Primary

Addresses

Primary practice location

19450 Deerfield Avenue, Suite 300
Leesburg, VA 20176-2681

Mailing address

224-D Cornwall St. NW Suite 403
Leesburg, VA 20176-2704
Phone (703) 737-6010

Other identifiers 2

IdentifierTypeStateIssuer
1093479339MedicaidVA
30017438600001MedicaidVA

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220414002347 VA Practitioner - Physician Assistant 0547656779 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Loudoun Medical Group, PCGroup PAC ID 0042119661, 272 clinicians

Practice addresses (Care Compare)

20955 Professional PLZ
Suite 200
Ashburn, VA 20147-3405
Phone (703) 729-7652

224 -D Cornwall St NW
Leesburg, VA 20176-2704

224 D Cornwall St NW
Suite 403
Leesburg, VA 20176-2704

44055 Riverside Pkwy
Leesburg, VA 20176-5176

Hospital & facility affiliations

  • Inova Loudoun Hospital Hospital, Leesburg, VA, CCN 490043

Merit-based Incentive Payment System (MIPS)

Final score
92.65 of 100Reported as apm
Quality
85.31
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Loudoun Medical Group, PC CurrentSince Apr 1, 2022 Accepting new patients
Loudoun Medical Group, PC Single Specialty CurrentSince Apr 1, 2022 Accepting new patients

Locations

20955 Professional Plz
Ste 200
Ashburn, VA 20147
Phone (703) 729-7652

24430 Stone Springs Blvd
Ste 275
Dulles, VA 20166
Phone (703) 858-3220

44055 Riverside Pkwy
Ste 116
Leesburg, VA 20176
Phone (703) 858-3220

44055 Riverside Pkwy
Ste 208
Leesburg, VA 20176
Phone (703) 729-7652

224D Cornwall St NW
Ste 403
Leesburg, VA 20176
Phone (703) 737-6001

19450 Deerfield Ave
Ste 300
Leesburg, VA 20176
Phone (703) 723-6774

921 E Main St
#D
Purcellville, VA 20132
Phone (703) 293-5242

24430 Stone Springs Blvd
Ste 100
Sterling, VA 20166
Phone (703) 723-6774

Interoperability endpoints

  • Direct secure messaging: jessica.erim@lmg1.eclinicaldirectplus.com

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1634860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709683200000",
    "number": "1093479339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224-D CORNWALL ST. NW SUITE 403",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201762704",
            "telephone_number": "703-737-6010",
            "fax_number": "703-443-8643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19450 DEERFIELD AVENUE, SUITE 300",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201762681",
            "telephone_number": "703-858-3220",
            "fax_number": "703-858-3221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERIM",
        "first_name": "JESSICA",
        "middle_name": "KENT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-22",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110008446",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1093479339",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30017438600001",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, VA

Sources for this page

Verify at the official NPI Registry.