NPIMap

Individual provider Active NPI

Jeremy Ravussin, MD

  • Internal Medicine Physician
  • Midlothian, VA
National Provider Identifier
1669747903
Registry record updated Jan 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101257793 Issued in VA
Practice address
611 Watkins Centre Pkwy
Suite 250
Midlothian, VA 23114-4404
Phone
(804) 423-8470
Fax
(804) 423-8471
NPI assigned
Mar 20, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0101257793 VA Primary

Addresses

Primary practice location

611 Watkins Centre Pkwy
Suite 250
Midlothian, VA 23114-4404

Mailing address

611 Watkins Centre Pkwy
Suite 250
Midlothian, VA 23114-4404
Phone (804) 423-8470

Other identifiers 1

IdentifierTypeStateIssuer
C09633OtherVAGROUP PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150803000366 VA Practitioner - Internal Medicine 2365756509 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Louisiana State University School of Medicine in New Orleans, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Douglas Avery and Associates LTDGroup PAC ID 3971412818, shared by 5 NPIs, 48 clinicians
Bon Secours Medical Group Richmond Primary Care LLCGroup PAC ID 3476986613, 91 clinicians
Professional Therapies of Roanoke, Inc.Group PAC ID 3375710619, shared by 5 NPIs, 272 clinicians

Practice addresses (Care Compare)

12725 Stone Village Way
Midlothian, VA 23113-2722
Phone (804) 245-8430

1362 Tappahannock Blvd
Tappahannock, VA 22560-9309
Phone (804) 443-5378

3000 G Stony Point Rd
Richmond, VA 23235-2349
Phone (804) 877-0008

611 Watkins Centre Pkwy
Suite 250
Midlothian, VA 23114-4404
Phone (804) 423-8470

6800 Woodlake Commons Loop
Midlothian, VA 23112-2281
Phone (804) 302-4589

Hospital & facility affiliations

  • Amedisys Home Health Home health agency, Midlothian, VA, CCN 497538
  • James River Home Health Agency Home health agency, Richmond, VA, CCN 497706
  • HCA Virginia Healthcare at Home Home health agency, North Chesterfield, VA, CCN 497625
  • At Home Care Home health agency, Mechanicsvlle, VA, CCN 497493
  • Bon Secours St Marys Hospital Hospital, Richmond, VA, CCN 490059
  • Bon Secours St Francis Medical Center Hospital, Midlothian, VA, CCN 490136
  • Bon Secours Richmond Community Hospital Hospital, Richmond, VA, CCN 490094
  • CJW Medical Center Hospital, Richmond, VA, CCN 490112
  • Bon Secours Memorial Regional Medical Center Hospital, Mechanicsville, VA, CCN 490069
  • Sheltering Arms Institute Inpatient rehabilitation facility, Richmond, VA, CCN 493036

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours St. Francis Medical Center LLC Current Accepting new patients
Bon Secours St. Francis Medical Center LLC CurrentSince Jul 31, 2015 Accepting new patients
Bon Secours St. Francis Medical Center LLC Internal Medicine CurrentSince Jul 31, 2015 Accepting new patients
Bon Secours-St. Mary'S Hospital of Richmond, Inc. CurrentSince Mar 15, 2020 Accepting new patients
Bon Secours Medical Group Richmond Primary Care LLC Internal Medicine CurrentSince Nov 17, 2024 Accepting new patients
Bon Secours St. Mary'S Hospital of Richmond LLC Current Accepting new patients
Bon Secours St Marys Hospital of Richmond LLC CurrentSince Mar 15, 2020 Accepting new patients
Bon Secours St Francis Medical Center LLC Past Accepting new patients
Bon Secours St. Francis Medical Center Inc Past Accepting new patients
Commonwealth Counseling Associates Inc Past Accepting new patients

Locations

611 Watkins Centre Pkwy
Ste 250
Midlothian, VA 23114
Phone (804) 423-8470

8580 Magellan Pkwy
Richmond, VA 23227
Phone (804) 627-5462

5855 Bremo Rd
Ste 306
Richmond, VA 23226
Phone (804) 287-7644

1362 Tappahannock Blvd
Tappahannock, VA 22560
Phone (804) 443-5378

Interoperability endpoints

  • Direct secure messaging: jravussin1154956@direct.bsmhealth.org

Organizations & group practices 10

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.

Hospital & facility affiliations 30

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1332201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452816000000",
    "number": "1669747903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 WATKINS CENTRE PKWY",
            "address_2": "SUITE 250",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231144404",
            "telephone_number": "804-423-8470",
            "fax_number": "804-423-8471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 WATKINS CENTRE PKWY",
            "address_2": "SUITE 250",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231144404",
            "telephone_number": "804-423-8470",
            "fax_number": "804-423-8471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAVUSSIN",
        "first_name": "JEREMY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-20",
        "last_updated": "2016-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101257793",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "C09633",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Midlothian, VA

Sources for this page

Verify at the official NPI Registry.