Provider Demographics
NPI:1083636500
Name:SIMMONS, JESSICA N (MD)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:N
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1307 ST GEORGE ST
Mailing Address - Street 2:
Mailing Address - City:CROZET
Mailing Address - State:VA
Mailing Address - Zip Code:22932-3015
Mailing Address - Country:US
Mailing Address - Phone:434-249-3581
Mailing Address - Fax:434-972-4266
Practice Address - Street 1:400 BRANDON AVE
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22903-3310
Practice Address - Country:US
Practice Address - Phone:434-982-3915
Practice Address - Fax:434-982-0193
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2020-07-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101239207208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010265118Medicaid
VA010265118Medicaid