Individual provider Active NPI

Jon Bledsoe Barlow III, PA

  • Surgical Physician Assistant
  • Charlottesville, VA
National Provider Identifier
1306209473
Registry record updated Jun 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
0110005310 Issued in VA
Practice address
595 Martha Jefferson Dr Ste 180
Charlottesville, VA 22911-4669
Phone
(434) 654-5575
Fax
(434) 654-5574
NPI assigned
Apr 5, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110-005310 VA
Surgical Physician Assistant 363AS0400X 0110005310 VA Primary

Addresses

Primary practice location

595 Martha Jefferson Dr Ste 180
Charlottesville, VA 22911-4669

Mailing address

PO Box 79777
Baltimore, MD 21279-0777
Phone (434) 654-7794

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
I20160624000818 VA Practitioner - Physician Assistant 8527359355 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Martha Jefferson Medical Group LLCGroup PAC ID 5991889081, 197 clinicians
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians

Practice addresses (Care Compare)

Charlottesville, VA 22911

1646 Park Ridge Dr
Crozet, VA 22932-3155
Phone (434) 654-2760

250 Merchant Walk SQ
Suite 1103
Charlottesville, VA 22902-6511
Phone (434) 328-4900

590 Peter Jefferson Pkwy
Suite 100
Charlottesville, VA 22911-4628
Phone (434) 654-8930

595 Martha Jefferson Dr
Charlottesville, VA 22911-4669

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0110-005310VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Martha Jefferson Hospital Past Accepting new patients

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 1

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": "1459814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622505600000",
    "number": "1306209473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 79777",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212790777",
            "telephone_number": "434-654-7794",
            "fax_number": "434-654-7752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "595 MARTHA JEFFERSON DR STE 180",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229114669",
            "telephone_number": "434-654-5575",
            "fax_number": "434-654-5574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARLOW",
        "first_name": "JON",
        "middle_name": "BLEDSOE",
        "name_suffix": "III",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-05",
        "last_updated": "2021-06-01",
        "certification_date": "2021-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110-005310",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "VA",
            "license": "0110005310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

Verify at the official NPI Registry.