Dara Courtney Wotherspoon, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110-004625 Issued in VA

Practice address

9763 Courthouse Rd
Spotsylvania, VA 22553-1915

Phone

(540) 786-1200

Fax

(540) 786-3195

NPI assigned

Jun 26, 2014

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

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

Specialty

Physician Assistant

Education

Eastern Virginia Medical School, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prime Care Family Care, Inc.Group PAC ID 7618959750, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Primecare Family Care, Inc.

  • Family Medicine Physician
  • Spotsylvania, VA
  • NPI 1780612424
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1403740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614297600000",
    "number": "1588079735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9763 COURTHOUSE RD",
            "city": "SPOTSYLVANIA",
            "state": "VA",
            "postal_code": "225531915",
            "telephone_number": "540-786-1200",
            "fax_number": "540-786-3195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9763 COURTHOUSE RD",
            "city": "SPOTSYLVANIA",
            "state": "VA",
            "postal_code": "225531915",
            "telephone_number": "540-786-1200",
            "fax_number": "540-786-3195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOTHERSPOON",
        "first_name": "DARA",
        "middle_name": "COURTNEY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-26",
        "last_updated": "2021-02-26",
        "certification_date": "2021-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110-004625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Wilson
• Pamela Rosetta Wilson
• Paige Suzanne Winfrey, RBT
• Sheronda Wingo
• Susan Regina Winter
• Barbara Alexis Wright
• Derek York
• Nicole Zaros, LPC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2021; 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.