Organization Active NPI

Virginia Skin, LLC

  • Dermatology Physician
  • Charlottesville, VA
National Provider Identifier
1255014486
Registry record updated Aug 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
VIRGINIA SKIN, LLC
Practice address
600 Peter Jefferson Pkwy Ste 190
Charlottesville, VA 22911-8835
Phone
(434) 260-5800
NPI assigned
Aug 14, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2024

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

Authorized official

Name
Dr. Gabrielle Willey, MDNPI 1356661466
Title
Physician
Phone
(434) 260-5800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

600 Peter Jefferson Pkwy Ste 190
Charlottesville, VA 22911-8835

Mailing address

1626 Hathaway St
Charlottesville, VA 22902-8737
Phone (434) 260-5800

Other practice location 1

1885 Seminole Trl
Charlottesville, VA 22901-1160
Phone (434) 260-5800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231026003569 VA Part B Supplier - Clinic/Group Practice 1355797325 Receives reassigned benefits from 2 practitioners
Practice locations: Charlottesville, VA; Richmond, VA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
49D2290076Virginia Skin, LLC600 Peter Jefferson Parkway, Suite 190, Charlottesville, VA 22911Certificate of waiverSep 19, 2027

National Provider Directory

National Provider Directory

Locations

1885 Seminole Trl
Ste 100
Charlottesville, VA 22901

600 Peter Jefferson Pkwy
Ste 190
Charlottesvle, VA 22911
Phone (434) 220-8620

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/ez_00421

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1691971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722556800000",
    "number": "1255014486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1626 HATHAWAY ST",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229028737",
            "telephone_number": "434-260-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 PETER JEFFERSON PKWY STE 190",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229118835",
            "telephone_number": "434-260-5800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1885 Seminole Trl",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229011160",
            "country_code": "US",
            "telephone_number": "434-260-5800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "VIRGINIA SKIN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-14",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A",
        "authorized_official_last_name": "WILLEY",
        "authorized_official_first_name": "GABRIELLE",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "434-260-5800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.