NPIMap

Individual provider Active NPI

Virna Lisa Simmons, MD

  • Family Medicine Physician
  • Stone Mountain, GA
National Provider Identifier
1912163684
Registry record updated Feb 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
060614 Issued in GA
Practice address
5582 Memorial Dr
Stone Mountain, GA 30083-3215
Phone
(404) 298-8998
Fax
(404) 298-7658
NPI assigned
Aug 1, 2008
Last updated
Feb 19, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 060614 GA Primary

Addresses

Primary practice location

5582 Memorial Dr
Stone Mountain, GA 30083-3215

Mailing address

4120 Five Forks Trickum Rd SW
Lilburn, GA 30047-3133
Phone (770) 921-6900

Other identifiers 1

IdentifierTypeStateIssuer
060614OtherGAGA LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20080827000346 GA Practitioner - Family Practice 0143396150 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Morehouse School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Emory Specialty Associates, LLCGroup PAC ID 3476559782, 706 clinicians
Physiotherapy Associates IncGroup PAC ID 3577470442, shared by 50 NPIs, 1,432 clinicians

Practice addresses (Care Compare)

1821 Clifton Rd NE
Atlanta, GA 30329-4021
Phone (404) 728-6812

966 A Killian Hill Rd SW
Lilburn, GA 30047-3102
Phone (770) 923-4815

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
060614GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Specialty Associates, LLC Family Medicine CurrentSince Sep 4, 2022 Accepting new patients
Medcura Health, Inc. CurrentSince Mar 1, 2015 Accepting new patients
Medcura Health, Inc. CurrentSince Mar 1, 2015 Accepting new patients

Locations

1776 Old Spring House Ln
Atlanta, GA 30338
Phone (770) 454-0091

1821 Clifton Rd NE
Atlanta, GA 30329
Phone (404) 728-6812

2201 Henderson Mill Rd NE
Ste 160
Atlanta, GA 30345
Phone (404) 251-2193

4120 Five Forks Trickum Rd SW
Ste 102
Lilburn, GA 30047
Phone (770) 923-6400

5582 Memorial Dr
Stone Mountain, GA 30083
Phone (404) 298-7658

770 Village Square Dr
Stone Mtn, GA 30083
Phone (404) 298-7658

Interoperability endpoints

  • Direct secure messaging: vsimmons20167@direct.emory.org

Organizations & group practices 3

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 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": "1217548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550534400000",
    "number": "1912163684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4120 FIVE FORKS TRICKUM RD SW",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300473133",
            "telephone_number": "770-921-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5582 MEMORIAL DR",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300833215",
            "telephone_number": "404-298-8998",
            "fax_number": "404-298-7658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "VIRNA",
        "middle_name": "LISA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-01",
        "last_updated": "2019-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "060614",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GA LICENSE",
            "identifier": "060614",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stone Mountain, GA

Sources for this page

Verify at the official NPI Registry.