Individual provider Active NPI

Jason Prater, DO, PA-C

  • Emergency Medicine Physician
  • Grundy, VA
National Provider Identifier
1649719014
Registry record updated Jun 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
0102208424 Issued in VA
Practice address
1535 Slate Creek Rd
Grundy, VA 24614-6974
Phone
(276) 935-1000
NPI assigned
Feb 18, 2017
Last updated
Jun 26, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-07092 NC
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 0102208424 VA Primary

Addresses

Primary practice location

1535 Slate Creek Rd
Grundy, VA 24614-6974

Mailing address

1039 Panorama Dr
Abingdon, VA 24210-4101

Other practice location 1

615 Ridge Rd
Roxboro, NC 27573-4629
Phone (336) 599-2121

Other practice location 2

500 J Clyde Morris Blvd
Newport News, VA 23601-1929
Phone (757) 612-7200

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
I20250825003848 VA Practitioner - Emergency Medicine 9335416163 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Lake Erie College of Osteopathic Medicine, Erie, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohio Valley Physicians IncGroup PAC ID 8729032966, 130 clinicians

Practice addresses (Care Compare)

1535 Slate Creek Rd
Grundy, VA 24614-6974
Phone (276) 935-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0102208424VAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ohio Valley Physicians Inc CurrentSince Jul 1, 2025 Accepting new patients
Ohio Valley Physicians Inc Emergency Medicine CurrentSince Jul 1, 2025 Accepting new patients

Locations

1535 Slate Creek Rd
Grundy, VA 24614
Phone (276) 935-1125

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1487376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750896000000",
    "number": "1649719014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1039 PANORAMA DR",
            "city": "ABINGDON",
            "state": "VA",
            "postal_code": "242104101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1535 SLATE CREEK RD",
            "city": "GRUNDY",
            "state": "VA",
            "postal_code": "246146974",
            "telephone_number": "276-935-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "615 Ridge Rd",
            "address_purpose": "LOCATION",
            "city": "Roxboro",
            "state": "NC",
            "postal_code": "275734629",
            "country_code": "US",
            "telephone_number": "336-599-2121",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 J Clyde Morris Blvd",
            "address_purpose": "LOCATION",
            "city": "Newport News",
            "state": "VA",
            "postal_code": "236011929",
            "country_code": "US",
            "telephone_number": "757-612-7200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRATER",
        "first_name": "JASON",
        "credential": "DO, PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-02-18",
        "last_updated": "2025-06-26",
        "certification_date": "2025-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-07092",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0102208424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grundy, VA

Sources for this page

Verify at the official NPI Registry.