Mia Jo Taveroni

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110011893 Issued in VA

Practice address

10 Stafford Lakes Pkwy Ste 102
Fredericksburg, VA 22406-7305

Phone

(540) 741-6982

NPI assigned

Jan 7, 2026

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Specialty

Physician Assistant

Education

Other, 2026

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1767744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780876800000",
    "number": "1205793502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1340 CENTRAL PARK BLVD STE 100",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224014940",
            "telephone_number": "540-741-6982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 STAFFORD LAKES PKWY STE 102",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224067305",
            "telephone_number": "540-741-6982"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "955 Wonder Rd Ste C",
            "address_purpose": "LOCATION",
            "city": "Stafford",
            "state": "VA",
            "postal_code": "225547798",
            "country_code": "US",
            "telephone_number": "540-741-7890",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "648 Mariann Pl",
            "address_purpose": "LOCATION",
            "city": "Township Of Washington",
            "state": "NJ",
            "postal_code": "076763934",
            "country_code": "US",
            "telephone_number": "201-663-0933",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11131 Journal Pkwy Ste A",
            "address_purpose": "LOCATION",
            "city": "King George",
            "state": "VA",
            "postal_code": "224853468",
            "country_code": "US",
            "telephone_number": "540-741-6982",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAVERONI",
        "first_name": "MIA",
        "middle_name": "JO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-01-07",
        "last_updated": "2026-06-08",
        "certification_date": "2026-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110011893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Elizabeth Tate, LPC
• Taurus Tatem, D.D.S.
• Jasmine Tatum
• Wendy Tatum, M.S., ED.S, NCSP
• Husayn Tavangar, MD
• Rajiv Tayal, M.D., M.P.H
• Beth Ann Taylor, CST, SA
• Emily Taylor
• Heaven Taylor
• Jessica L Taylor, NP

• Physician Assistant in Fredericksburg, VA
• Providers in Fredericksburg, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2026; 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.

Verify at the official NPI Registry.