Active NPI
Sara Gunnoe, PA-C
- Physician Assistant
- Charlottesville, VA
National Provider Identifier
1447634316
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0110008092
- Practice address
- 1204 W Main St
Charlottesville, VA 22903-2824 - Phone
- (434) 443-3869
- Fax
- (434) 924-3300
- NPI assigned
- Jul 10, 2015
- 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 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 0110008092 | VA | |
| Pediatric Hematology & Oncology Physician | 2080P0207X | 0110008092 | VA | |
| Physician Assistant | 363A00000X | 2729 | WV | |
| Medical Physician Assistant | 363AM0700X | PA60709751 | WA | |
| Physician Assistant | 363A00000X | 0110008092 | VA | Primary |
Addresses
Primary practice location
1204 W Main St
Charlottesville, VA 22903-2824
Mailing address
PO Box 9007
Charlottesville, VA 22906-9007
Phone (434) 295-1000
Other practice location 1
825 Eastlake Ave E
Seattle, WA 98109-4405
Phone (206) 288-1000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447634316 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2729 | WV | MD | General Practice Dentistry |
| 0110008092 | VA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1436486400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1685577600000",
"number": "1447634316",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 9007",
"city": "CHARLOTTESVILLE",
"state": "VA",
"postal_code": "229069007",
"telephone_number": "434-295-1000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1204 W MAIN ST",
"city": "CHARLOTTESVILLE",
"state": "VA",
"postal_code": "229032824",
"telephone_number": "434-443-3869",
"fax_number": "434-924-3300"
}
],
"practiceLocations": [
{
"address_1": "825 Eastlake Ave E",
"address_purpose": "LOCATION",
"city": "Seattle",
"state": "WA",
"postal_code": "981094405",
"country_code": "US",
"telephone_number": "206-288-1000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GUNNOE",
"first_name": "SARA",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-07-10",
"last_updated": "2023-06-01",
"certification_date": "2023-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "VA",
"license": "0110008092",
"primary": false
},
{
"code": "2080P0207X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Hematology-Oncology",
"state": "VA",
"license": "0110008092",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "WV",
"license": "2729",
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "WA",
"license": "PA60709751",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "VA",
"license": "0110008092",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1447634316",
"state": "WA"
}
],
"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 Jun 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.