Individual provider Active NPI

Samuel Cross

  • Pediatrics Physician
  • Fishersville, VA
National Provider Identifier
1407389703
Registry record updated Sep 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
0101268899 Issued in VA
Practice address
57 Beam LN Ste 202
Fishersville, VA 22939-2350
Phone
(540) 932-0980
Fax
(540) 932-0979
NPI assigned
Apr 4, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 0101268899 VA Primary

Addresses

Primary practice location

57 Beam LN Ste 202
Fishersville, VA 22939-2350

Mailing address

PO Box 749112
Atlanta, GA 30374-9112

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address scross214826@direct.healthsystem.virginia.edu Direct

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200610003515 VA Practitioner - Pediatric Medicine 3577833276 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
University of Virginia Physicians Group CurrentSince Jun 1, 2020 Accepting new patients
Jha MD PC Pediatrics PastSince Jun 1, 2020 Accepting new patients

Locations

1215 Lee St
#800501
Charlottesvle, VA 22908

1215 Lee St
Fl 8
Charlottesvle, VA 22908
Phone (434) 924-2500

57 Beam Ln
Ste 202
Fishersville, VA 22939
Phone (540) 932-0980

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.

NPI Registry JSON

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

{
    "created_epoch": "1491264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789776000000",
    "number": "1407389703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 749112",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303749112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 BEAM LN STE 202",
            "city": "FISHERSVILLE",
            "state": "VA",
            "postal_code": "229392350",
            "telephone_number": "540-932-0980",
            "fax_number": "540-932-0979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROSS",
        "first_name": "SAMUEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-04",
        "last_updated": "2026-09-19",
        "certification_date": "2026-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101268899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "scross214826@direct.healthsystem.virginia.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "57 Beam Ln Ste 202",
            "city": "Fishersville",
            "state": "VA",
            "country_code": "US",
            "postal_code": "229392350",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fishersville, VA

Sources for this page

Verify at the official NPI Registry.