Active NPI
Karry Elizabeth Simons, CSA, L-SA
- Surgical Physician Assistant
- Woodbridge, VA
National Provider Identifier
1932338803
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- SA0013
- Practice address
- 12741 Darby Brook CR
Suite 201
Woodbridge, VA 22192 - Phone
- (443) 285-3806
- NPI assigned
- Jul 13, 2009
- Last updated
- Aug 19, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | SA0013 | DC | Primary |
Addresses
Primary practice location
12741 Darby Brook CR
Suite 201
Woodbridge, VA 22192
Mailing address
15201 Derbyshire Way
Accokeek, MD 20607-2828
Phone (443) 285-3806
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SA0013 | DC | MD | Surgical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1247443200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1282176000000",
"number": "1932338803",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15201 DERBYSHIRE WAY",
"city": "ACCOKEEK",
"state": "MD",
"postal_code": "206072828",
"telephone_number": "443-285-3806"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12741 DARBY BROOK CR",
"address_2": "SUITE 201",
"city": "WOODBRIDGE",
"state": "VA",
"postal_code": "22192",
"telephone_number": "443-285-3806"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMONS",
"first_name": "KARRY",
"middle_name": "ELIZABETH",
"name_prefix": "Ms.",
"credential": "CSA, L-SA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-07-13",
"last_updated": "2010-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "DC",
"license": "SA0013",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Woodbridge, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.