Robert Reid Nottingham Jr., CSA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

Practice address

2300 Wilson Blvd Ste 700
Arlington, VA 22201-5435

Phone

(757) 439-0033

NPI assigned

Jun 3, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Commonwealth Surgical Professionals LLC

  • Surgical Physician Assistant
  • Arlington, VA
  • NPI 1518655943
  NPD Authorized official

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

{
    "created_epoch": "1559520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685923200000",
    "number": "1164080321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 WILSON BLVD STE 700",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222015435",
            "telephone_number": "757-439-0033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 WILSON BLVD STE 700",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222015435",
            "telephone_number": "757-439-0033"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8116 Arlington Blvd Ste 183",
            "address_purpose": "LOCATION",
            "city": "Falls Church",
            "state": "VA",
            "postal_code": "220421002",
            "country_code": "US",
            "telephone_number": "703-659-4557",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOTTINGHAM",
        "first_name": "ROBERT",
        "middle_name": "REID",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "CSA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-03",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "VA",
            "license": "5016",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Northern Virginia Physicians Services,LLC
• Northern Virginia Physicians to Women, LTD.
• Northern Virginia Radiology Consultants, PLLC
• Northstar Psychological Services
• Michael P. Notarianni, M.D.
• Nouveau Psychological Wellness, PLLC
• Nova Family Dental Center
• Nova Internal Medicine, Inc
• Nova Optique and Eyecare
• Nova Pharmacy LLC

• Surgical Physician Assistant in Arlington, VA
• Providers in Arlington, VA by specialty
• Surgical Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2023; 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.