Active NPI
Charlotte A Fitzsimmons, PA
- Medical Physician Assistant
- York, PA
National Provider Identifier
1871781278
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 0110002650
- Practice address
- 2319 S George St
York, PA 17403-5009 - Phone
- (717) 812-4090
- NPI assigned
- Oct 10, 2007
- Last updated
- Feb 24, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | |||
| Medical Physician Assistant | 363AM0700X | 0110002650 | VA | Primary |
Addresses
Primary practice location
2319 S George St
York, PA 17403-5009
Mailing address
201 Tanyard Rd
Conestoga, PA 17516-9101
Phone (703) 463-7056
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871781278 | Medicaid | VA | |
| 4330530001 | Other | DMERC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0110002650 | VA | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ehra Medical Services of Virginia, PC | Past | Accepting new patients | |
| VA-I Medical Services PC | Past | Accepting new patients |
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1191974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1456272000000",
"number": "1871781278",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 TANYARD RD",
"city": "CONESTOGA",
"state": "PA",
"postal_code": "175169101",
"telephone_number": "703-463-7056"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2319 S GEORGE ST",
"city": "YORK",
"state": "PA",
"postal_code": "174035009",
"telephone_number": "717-812-4090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FITZSIMMONS",
"first_name": "CHARLOTTE",
"middle_name": "A",
"name_prefix": "Mrs.",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-10-10",
"last_updated": "2016-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": null,
"license": null,
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "VA",
"license": "0110002650",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1871781278",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DMERC",
"identifier": "4330530001",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in York, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.