Individual provider Active NPI

Karry Elizabeth Simons, CSA, L-SA

  • Surgical Physician Assistant
  • Woodbridge, VA
National Provider Identifier
1932338803
Registry record updated Aug 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
SA0013 Issued in DC
Practice address
12741 Darby Brook CR
Suite 201
Woodbridge, VA 22192
Phone
(443) 285-3806
NPI assigned
Jul 13, 2009
Last updated
Aug 19, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
SA0013DCMDSurgical 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.

Verify at the official NPI Registry.