Individual provider Active NPI

Daniel Joseph Fitzsimmons, MD

  • Pediatrics Physician
  • Winchester, VA
National Provider Identifier
1659380467
Registry record updated Jun 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
0101233636 Issued in VA
Practice address
1330 Amherst St
Winchester, VA 22601-3054
Phone
(304) 263-4999
Fax
(304) 263-0984
NPI assigned
Aug 8, 2006
Last updated
Jun 28, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 200400859 NC
Pediatrics Physician 208000000X 0101233636 VA Primary

Addresses

Primary practice location

1330 Amherst St
Winchester, VA 22601-3054

Mailing address

PO Box 1146
Martinsburg, WV 25402
Phone (540) 722-2369

Other identifiers 1

IdentifierTypeStateIssuer
010289203MedicaidVA

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
I20090617000472 VA Practitioner - Pediatric Medicine 5991771560 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200400859NCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shenandoah Valley Medical System, Inc. CurrentSince Oct 6, 2012 Accepting new patients
Shenandoah Valley Medical System, Inc. Current Accepting new patients
Shenandoah Valley Medical System, Inc. CurrentSince Oct 6, 2012 Accepting new patients
Goldsboro Pediatrics PA Pediatrics Past Accepting new patients
Goldsboro Pediatrics PA Pediatrics Past Accepting new patients
Shenandoah Valley Medical System, Inc. Past Accepting new patients

Locations

130 Peyton St
Winchester, VA 22601
Phone (540) 678-1433

1330 Amherst St
Winchester, VA 22601
Phone (540) 662-0711

1330 Amherst St
Ste C
Winchester, VA 22601
Phone (540) 662-6400

Interoperability endpoints

  • Direct secure messaging: daniel.fitzsimmons.1@32629.direct.athenahealth.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561680000000",
    "number": "1659380467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1146",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "25402",
            "telephone_number": "540-722-2369",
            "fax_number": "542-722-6601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 AMHERST ST",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226013054",
            "telephone_number": "304-263-4999",
            "fax_number": "304-263-0984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZSIMMONS",
        "first_name": "DANIEL",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2019-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "200400859",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101233636",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010289203",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winchester, VA

Sources for this page

Verify at the official NPI Registry.