Individual provider Active NPI

Jourdann Elizabeth Kirk, PA-C

  • Physician Assistant
  • Forest, VA
National Provider Identifier
1699569707
Registry record updated Apr 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110010738 Issued in VA
Practice address
1175 Corporate Park Dr
Forest, VA 24551-2238
Phone
(434) 525-6964
NPI assigned
Apr 7, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110010738 VA Primary

Addresses

Primary practice location

1175 Corporate Park Dr
Forest, VA 24551-2238

Mailing address

220 Two Creek Dr
Lynchburg, VA 24502-5137

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250613002246 VA Practitioner - Physician Assistant 0042721326 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Privia Medical Group, LLCGroup PAC ID 4385682061, 1,522 clinicians

Practice addresses (Care Compare)

1088 London Links Dr
Forest, VA 24551-4662
Phone (434) 534-6868

1175 Corporate Park Dr
Forest, VA 24551-2238
Phone (434) 525-6964

14005 Wards Rd
Suite a
Lynchburg, VA 24501-7127
Phone (434) 239-0132

2215 Landover PL
Lynchburg, VA 24501-2115
Phone (434) 947-3944

8644 Sudley Rd
Suite 220
Manassas, VA 20110-4425
Phone (571) 366-8845

950 N Glebe Rd
Suite 700
Arlington, VA 22203-4173

Hospital & facility affiliations

  • Centra Health - Lynchburg Gen Hospital Hospital, Lynchburg, VA, CCN 490021

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC CurrentSince May 1, 2025 Accepting new patients
Privia Medical Group, LLC CurrentSince May 1, 2025 Accepting new patients

Locations

950 N Glebe Rd
Ste 700
Arlington, VA 22203
Phone (484) 228-1065

1175 Corporate Park Dr
Forest, VA 24551
Phone (434) 525-6964

8644 Sudley Rd
#220
Manassas, VA 20110

Interoperability endpoints

  • Direct secure messaging: jourdann.kirk.1@8042.direct.athenahealth.com

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 and National Provider Directory roles.

Hospital & facility affiliations 7

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": "1743984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743984000000",
    "number": "1699569707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 TWO CREEK DR",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245025137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1175 CORPORATE PARK DR",
            "city": "FOREST",
            "state": "VA",
            "postal_code": "245512238",
            "telephone_number": "434-525-6964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRK",
        "first_name": "JOURDANN",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-07",
        "last_updated": "2025-04-07",
        "certification_date": "2025-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110010738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest, VA

Sources for this page

Verify at the official NPI Registry.