Active NPI 1003194218 Individual Practitioner Male Practitioner

Dr. Jonathan L Siddon , DO

Internal Medicine • Gainesville, VA

✓ Accepts Medicare Assignment Telehealth Available

Professional Overview & Biography Verified Profile Summary

Dr. Jonathan Siddon, DO is a certified Internal Medicine practicing in Gainesville, VA. With approximately 15 years of clinical experience since completing medical education in 2011, Dr. Siddon delivers high-quality medical care to the local community at 7051 HEATHCOTE VILLAGE WAY STE 140.

Dr. Siddon maintains professional affiliations with Privia Medical Group, Llc, Legacy Healthcare Services Inc and accepts Medicare assignment . Telehealth and virtual consultation options are available for eligible patients.

Frequently performed procedures and clinical services include established patient outpatient office visit, visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's, insertion of needle into vein for collection of blood sample. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

7051 Heathcote Village Way Ste 140

Gainesville, VA 201553198

Telephone 5716854388

Fax 7037435275

Medicare Profile & Education

Medical School

Other

Graduation Year

2011

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

Telehealth Services Available

Specialty Benchmarks & Practice Insights

Comparative analytics for Internal Medicine in Gainesville, VA

Established Specialist (10-20 Yrs)

Practitioner Clinical Experience

15 Yrs -9.9 yrs vs City Avg

City Avg: 24.9 Yrs

State Avg: 26.1 Yrs

Regional Practice Density

9 Specialists

Practicing in Gainesville, VA (3758 Statewide)

Telehealth Adoption Rate

55.6% Regional Adoption

✓ Offers Virtual Consultations

Medicare Pricing Discount

60.0% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Siddon (15 Years) 15 Yrs

Gainesville Specialty Average (24.9 Years) 24.9 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	423	211	$304.00	$121.14
G2211 Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's	386	217	$44.00	$15.81
36415 Insertion of needle into vein for collection of blood sample	340	214	$11.22	$8.58
99213 Established patient office or other outpatient visit, typically 15 minutes	187	131	$206.00	$87.53
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	168	168	$358.00	$123.88
93000 Routine ekg using at least 12 leads including interpretation and report	95	90	$67.00	$13.79
99457 Management using the results of remote vital sign monitoring per calendar month, first 20 minutes	67	11	$147.00	$47.39
G0008 Administration of influenza virus vaccine	57	56	$73.00	$31.41
90653 Vaccine for influenza for injection into muscle	54	54	$149.00	$81.82
87804 Detection test by immunoassay with direct visual observation for influenza virus	31	14	$38.00	$16.22
90677 Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use	30	30	$662.00	$290.55
G0009 Administration of pneumococcal vaccine	30	30	$73.00	$31.41
90480 Admn sarscov2 vacc 1 dose	28	28	$120.00	$41.89
91320 Sarscv2 vac 30mcg trs-suc im	28	28	$328.00	$152.78
87426 Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus	27	24	$128.00	$34.62
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	27	27	$466.00	$161.72
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	23	22	$125.00	$54.91
81003 Automated urinalysis test	19	16	$8.00	$2.10
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	18	17	$405.00	$164.48
99495 Transitional care management services for problem of at least moderate complexity	13	13	$464.00	$187.66

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	422	192	$304.00	$124.37
36415 Insertion of needle into vein for collection of blood sample	250	165	$9.89	$8.37
99213 Established patient office or other outpatient visit, typically 15 minutes	242	138	$206.00	$86.71
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	138	138	$358.00	$125.32
93000 Routine ekg using at least 12 leads including interpretation and report	85	80	$67.00	$14.00
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	56	56	$466.00	$162.99
G0008 Administration of influenza virus vaccine	45	42	$73.00	$30.15
90694 Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage	44	42	$166.00	$75.56
90677 Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use	43	43	$662.00	$275.64
G0009 Administration of pneumococcal vaccine	43	43	$73.00	$29.45
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	31	23	$405.00	$157.51
87428 Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus and influenza	24	20	$184.00	$50.65
81003 Automated urinalysis test	19	15	$8.00	$2.20
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	18	18	$306.00	$110.02
92228 Imaging of retina with remote review by physician	16	16	$102.00	$28.74
87426 Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus	15	15	$128.00	$34.62
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	11	11	$125.00	$55.44

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	338	141	$304.00	$126.37
36415 Insertion of needle into vein for collection of blood sample	237	140	$8.00	$2.96
99213 Established patient office or other outpatient visit, typically 15 minutes	194	108	$206.00	$89.62
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	94	94	$357.61	$128.42
93000 Routine ekg using at least 12 leads including interpretation and report	90	76	$67.00	$14.29
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	54	35	$405.00	$166.80
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	54	54	$466.00	$166.83
G0008 Administration of influenza virus vaccine	32	32	$73.00	$29.34
G0009 Administration of pneumococcal vaccine	32	32	$73.00	$29.42
87426 Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus	31	23	$128.00	$34.76
90694 Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage	30	30	$166.00	$70.25
90677 Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use	26	26	$662.00	$278.27
81003 Automated urinalysis test	24	18	$8.00	$2.22
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	24	24	$579.00	$212.68
87428 Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus and influenza	22	19	$184.00	$30.33
0124A Fee covid-19 vac 13 res	15	15	$120.00	$38.81
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	12	12	$462.00	$166.49
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	11	11	$478.00	$165.54

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	163	68	$304.00	$129.61
36415 Insertion of needle into vein for collection of blood sample	105	68	$8.00	$3.00
99213 Established patient office or other outpatient visit, typically 15 minutes	83	49	$206.00	$91.15
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	53	53	$466.00	$167.99
93000 Routine ekg using at least 12 leads including interpretation and report	52	41	$67.00	$14.23
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	51	51	$321.00	$134.63
G0008 Administration of influenza virus vaccine	27	27	$73.00	$17.01
90694 Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage	25	25	$153.00	$66.43
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	16	16	$306.00	$113.90
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	15	15	$125.00	$55.02

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	423	257	$304.00	$125.51
80053 Blood test, comprehensive group of blood chemicals	214	171	$36.00	$10.50
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	209	168	$27.00	$7.69
99213 Established patient office or other outpatient visit, typically 15 minutes	204	143	$206.00	$86.31
36415 Insertion of needle into vein for collection of blood sample	201	150	$8.00	$2.93
84481 Thyroid hormone, t3 measurement, free	164	146	$58.00	$16.56
84439 Thyroxine (thyroid chemical), free	163	146	$31.00	$8.82
84443 Blood test, thyroid stimulating hormone (TSH)	160	143	$57.00	$16.60
80061 Blood test, lipids (cholesterol and triglycerides)	152	129	$46.00	$13.19
83036 Hemoglobin A1C level	117	100	$33.00	$9.42
93000 Routine ekg using at least 12 leads including interpretation and report	106	95	$67.00	$20.12
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	92	75	$405.00	$167.96
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	74	74	$321.00	$133.79
82306 Vitamin d-3 level	42	37	$101.00	$28.86
81002 Urinalysis, manual test	41	35	$9.00	$3.38
G0008 Administration of influenza virus vaccine	33	33	$73.00	$19.40
90653 Vaccine for influenza for injection into muscle	31	31	$143.68	$55.57
85610 Blood test, clotting time	28	12	$13.00	$4.26
84153 Psa (prostate specific antigen) measurement, total	19	16	$63.00	$18.33
G0103 Prostate cancer screening; prostate specific antigen test (psa)	18	18	$63.00	$19.22
G0447 Face-to-face behavioral counseling for obesity, 15 minutes	17	15	$72.00	$30.09
80048 Blood test, basic group of blood chemicals (calcium, total)	17	16	$29.00	$8.43
99441 Telephone medical discussion with physician, 5-10 minutes	15	13	$113.67	$52.31
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	15	15	$478.00	$198.49
82570 Creatinine level to test for kidney function or muscle injury	15	14	$18.00	$4.82
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	14	14	$466.00	$190.72
82043 Urine microalbumin (protein) level	12	11	$20.00	$5.27
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	11	11	$151.00	$62.78
G0444 Annual depression screening, 5 to 15 minutes	11	11	$51.00	$21.58
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	11	11	$195.00	$118.98
G0009 Administration of pneumococcal vaccine	11	11	$73.00	$19.38

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	437	252	$266.04	$123.00
36415 Insertion of needle into vein for collection of blood sample	330	242	$8.96	$2.90
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	255	209	$32.45	$8.43
99213 Established patient office or other outpatient visit, typically 15 minutes	189	133	$202.98	$83.27
80053 Blood test, comprehensive group of blood chemicals	187	168	$38.89	$11.46
80061 Blood test, lipids (cholesterol and triglycerides)	163	146	$49.92	$14.31
84481 Thyroid hormone, t3 measurement, free	156	143	$68.15	$18.32
84439 Thyroxine (thyroid chemical), free	154	141	$51.29	$9.76
84443 Blood test, thyroid stimulating hormone (TSH)	153	141	$60.71	$18.06
93000 Routine ekg using at least 12 leads including interpretation and report	99	92	$63.61	$19.68
83036 Hemoglobin A1C level	98	90	$50.99	$10.35
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	66	39	$198.79	$77.38
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	58	53	$375.86	$162.97
82306 Vitamin d-3 level	49	45	$122.10	$32.23
85610 Blood test, clotting time	42	17	$27.14	$4.20
G0103 Prostate cancer screening; prostate specific antigen test (psa)	33	33	$69.55	$20.03
G0008 Administration of influenza virus vaccine	32	32	$71.97	$19.06
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	31	28	$302.23	$145.05
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	29	11	$69.59	$19.35
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	29	18	$137.93	$51.29
81002 Urinalysis, manual test	28	26	$9.00	$3.41
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	23	18	$250.09	$102.86
90653 Vaccine for influenza for injection into muscle	23	23	$94.00	$58.34
81000 Manual urinalysis test with examination using microscope, non-automated	18	18	$10.00	$3.94
82728 Ferritin (blood protein) level	14	13	$78.00	$14.85
84466 Transferrin (iron binding protein) level	14	13	$46.29	$13.90
83540 Iron level	14	13	$28.86	$7.05
80048 Blood test, basic group of blood chemicals (calcium, total)	12	11	$63.17	$9.21

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	466	251	$225.00	$121.34
99213 Established patient office or other outpatient visit, typically 15 minutes	327	197	$200.00	$82.24
36415 Insertion of needle into vein for collection of blood sample	306	217	$10.00	$2.90
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	231	188	$40.00	$9.36
80061 Blood test, lipids (cholesterol and triglycerides)	183	160	$55.00	$16.13
84443 Blood test, thyroid stimulating hormone (TSH)	158	149	$65.00	$20.22
84481 Thyroid hormone, t3 measurement, free	158	149	$80.00	$20.26
84439 Thyroxine (thyroid chemical), free	155	147	$75.00	$10.85
85610 Blood test, clotting time	133	23	$40.00	$4.75
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	115	21	$150.00	$50.38
93000 Routine ekg using at least 12 leads including interpretation and report	90	81	$60.00	$19.62
83036 Hemoglobin A1C level	83	75	$74.00	$11.75
80053 Blood test, comprehensive group of blood chemicals	82	69	$45.00	$12.78
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	60	55	$80.00	$25.25
99490 Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month	59	16	$95.00	$47.54
82306 Vitamin d-3 level	54	50	$148.00	$35.82
81000 Manual urinalysis test with examination using microscope, non-automated	46	37	$10.00	$3.94
G0103 Prostate cancer screening; prostate specific antigen test (psa)	39	39	$75.00	$21.69
G0008 Administration of influenza virus vaccine	35	35	$40.00	$23.04
90674 Influenza vaccine, quadrivalent derived from cell cultures, preservative and antibiotic free	29	29	$35.00	$23.57
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	21	15	$200.00	$73.56
82728 Ferritin (blood protein) level	20	20	$102.00	$16.49
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	20	12	$40.00	$23.87
84466 Transferrin (iron binding protein) level	20	20	$54.00	$15.44
83540 Iron level	20	20	$34.00	$7.83
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	19	19	$325.00	$180.02
80048 Blood test, basic group of blood chemicals (calcium, total)	18	13	$70.00	$10.23
82043 Urine microalbumin (protein) level	11	11	$76.00	$7.00
93306 Ultrasound of heart with color-depicted blood flow, rate, direction and valve function	11	11	$750.00	$237.70

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	566	283	$225.00	$119.34
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	263	215	$40.00	$10.41
36415 Insertion of needle into vein for collection of blood sample	243	174	$10.00	$2.92
99213 Established patient office or other outpatient visit, typically 15 minutes	233	165	$200.00	$81.36
85610 Blood test, clotting time	178	36	$40.00	$5.28
80061 Blood test, lipids (cholesterol and triglycerides)	158	140	$55.00	$17.83
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	151	132	$80.00	$23.37
84443 Blood test, thyroid stimulating hormone (TSH)	141	128	$65.00	$22.59
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	137	32	$150.00	$49.83
84481 Thyroid hormone, t3 measurement, free	137	125	$80.00	$22.78
84439 Thyroxine (thyroid chemical), free	136	124	$75.00	$12.12
80053 Blood test, comprehensive group of blood chemicals	107	89	$45.00	$14.03
99490 Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month	89	31	$95.00	$47.38
93000 Routine ekg using at least 12 leads including interpretation and report	82	76	$60.00	$19.33
82306 Vitamin d-3 level	57	51	$148.00	$39.80
81000 Manual urinalysis test with examination using microscope, non-automated	57	45	$10.00	$4.26
83036 Hemoglobin A1C level	55	49	$74.00	$13.05
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	51	43	$275.00	$159.98
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	50	32	$250.00	$93.32
G0008 Administration of influenza virus vaccine	32	32	$40.00	$29.60
Q2037 Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluvirin)	32	32	$25.00	$17.25
G0103 Prostate cancer screening; prostate specific antigen test (psa)	23	23	$75.00	$24.73
99306 Initial nursing facility visit, typically 45 minutes per day	21	21	$350.00	$175.15
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	20	20	$325.00	$180.06
80048 Blood test, basic group of blood chemicals (calcium, total)	18	18	$70.00	$11.37
83735 Magnesium level	12	11	$25.00	$9.01
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	11	11	$230.00	$192.05

Medical Specialties & State Licenses

CMS Verified: 2021-04-12

Internal Medicine Primary Specialty

NUCC Taxonomy Code: 207R00000X

State License VA 0102203729

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Hospital & Practice Group Affiliations

Privia Medical Group, Llc

950 N Glebe Rd, Arlington, VA 222034173

Privia Medical Group, Llc

8644 Sudley Rd, Manassas, VA 201104425

Phone: 5713668845

Legacy Healthcare Services Inc

9642 Burke Lake Rd, Burke, VA 220153052

Phone: 7035437920

Privia Medical Group, Llc

950 N Glebe Rd, Arlington, VA 222034173

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners

Nidhi Patel , PA-C

Physician Assistant - Medical

NPI 1013804293

Physician Assistant (Certified)

Madison Butz , PA-C

Physician Assistant

NPI 1528768959

Physician Assistant (Certified)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

13 Historical Events

📍

Updated Practice Location February 19, 2021

Registered at 7051 HEATHCOTE VILLAGE WAY STE 140, GAINESVILLE, VA 201553198 (Tel: 5716854388)

📍

Updated Business Mailing Address February 19, 2021

Registered at 7051 HEATHCOTE VILLAGE WAY STE 140, GAINESVILLE, VA 201553198 (Tel: 5716854388)

✅

NPI Profile Active January 19, 2017

NPI status registered as active in NPPES database

📍

Updated Practice Location January 19, 2017

Registered at 7764 ARMISTEAD RD, 240, LORTON, VA 220791919 (Tel: 7033393806)

📍

Updated Business Mailing Address January 19, 2017

Registered at 8988 LORTON STATION BLVD, 100, LORTON, VA 220794756 (Tel: 7037802800)

👤

Provider Name / Credentials Updated January 19, 2017

Recorded as JONATHAN SIDDON, D.O.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) January 19, 2017

Internal Medicine (License #0102203729 in VA)

✅

NPI Profile Active July 22, 2011

NPI status registered as active in NPPES database

📍

Updated Practice Location July 22, 2011

Registered at 4300 LONDONDERRY RD, HARRISBURG, PA 171095317 (Tel: 7172318900)

📍

Updated Business Mailing Address July 22, 2011

Registered at 1932 SUSQUEHANNA ST, HARRISBURG, PA 171022239 (Tel: 7039809014)

👤

Provider Name / Credentials Updated July 22, 2011

Recorded as JONATHAN SIDDON, D.O.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) July 22, 2011

Internal Medicine (License #OT013959 in PA)

🟢

Initial NPI Registration & Enumeration July 22, 2011

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1003194218

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: July 22, 2011

Last Update: April 12, 2021

Sole Proprietor: No

Update or Correct Profile

Mailing Address

7051 Heathcote Village Way Ste 140

Gainesville, VA 201553198

Phone: 5716854388

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

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