Active NPI
Shimeal Gordon
- Gerontology Nurse Practitioner
- Fredericksburg, VA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Nurse Practitioner
- License
- 0024193790
- Practice address
- 9530 Cosner Dr Ste 200
Fredericksburg, VA 22408-7760 - Phone
- (540) 373-1331
- NPI assigned
- Jun 13, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | 0024193790 | VA | Primary |
| Home Health Registered Nurse | 163WH0200X | 0001289844 | VA |
Addresses
Primary practice location
9530 Cosner Dr Ste 200
Fredericksburg, VA 22408-7760
Mailing address
9530 Cosner Dr Ste 200
Fredericksburg, VA 22408-7760
Phone (540) 373-1331
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2024
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
950 N Glebe Rd
Suite 700
Arlington, VA 22203-4173
Hospital & facility affiliations
- Mary Washington Hospital
- Spotsylvania Regional Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0001289844 | VA | MD | Home Health Registered Nurse |
| 0024193790 | VA | MD | Gerontology Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Privia Medical Group, LLC | Current | Accepting new patients | |
| Privia Medical Group, LLC | Current | Accepting new patients | |
| Nova Physician Wellness Center PLLC | Past | Accepting new patients |
Locations
2500 Charles St
Fredericksburg, VA 22401
Phone (540) 373-1331
8644 Sudley Rd
#220
Manassas, VA 20110
Interoperability endpoints
- https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
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 and National Provider Directory roles.
-
- Internal Medicine Physician
- Arlington, VA
- NPI 1013042480
-
- Pain Medicine (Psychiatry & Neurology) Physician
- Rockville, MD
- NPI 1811715436
-
- Family Medicine Physician
- Fairfax, VA
- NPI 1215307400
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Fredericksburg, VA
- NPI 1942288527
-
- Cardiovascular Disease Physician
- Fredericksburg, VA
- NPI 1013089879
Hospital
-
- General Acute Care Hospital
- Fredericksburg, VA
- NPI 1376876664
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1718236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1762041600000",
"number": "1194568683",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9530 COSNER DR STE 200",
"city": "FREDERICKSBURG",
"state": "VA",
"postal_code": "224087760",
"telephone_number": "540-373-1331"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9530 COSNER DR STE 200",
"city": "FREDERICKSBURG",
"state": "VA",
"postal_code": "224087760",
"telephone_number": "540-373-1331"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORDON",
"first_name": "SHIMEAL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-06-13",
"last_updated": "2025-11-02",
"certification_date": "2025-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "VA",
"license": "0024193790",
"primary": true
},
{
"code": "163WH0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Home Health",
"state": "VA",
"license": "0001289844",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fredericksburg, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.