THRESA HELEN SIMON (NPI# 1003871989) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003871989 |
| Entity Type | Individual |
| Full Name | THRESA HELEN SIMON |
| Credential | M.D. |
| Practice Address |
269 Medical Park Blvd Petersburg VA 23805-9337 |
| Practice Telephone | 8048610700 |
| Practice Fax Number | 8048634626 |
| Mailing Telephone | 8048610700 |
| Mailing Fax Number | 8048634626 |
| Enumeration Date | 2006-04-20 |
| Last Update Date | 2013-10-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
0101840405 | VA | Allopathic & Osteopathic Physicians |
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
0101840405 | VA | Allopathic & Osteopathic Physicians |
| Street Address |
269 MEDICAL PARK BLVD |
| City | PETERSBURG |
| State | VA |
| Zip Code | 23805-9337 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700857836 | Haluk K Aydin | Psychiatry & Neurology | 269 Medical Park Blvd, Petersburg, VA 23805-9337 | 2006-01-27 |
| 1104452010 | Olivia Mendoza | Nurse Practitioner | 269 Medical Park Blvd, Petersburg, VA 23805-9337 | 2020-03-23 |
| 1700234622 | Sunny Hong | Psychologist | 269 Medical Park Blvd, Petersburg, VA 23805-9337 | 2016-06-01 |
| 1114121829 | Devi Vasu | Psychiatry & Neurology | 269 Medical Park Blvd, Petersburg, VA 23805-9337 | 2007-06-14 |
| 1700894466 | Virginia South Psychiatric & Family Services | Psychiatry & Neurology | 269 Medical Park Blvd, Petersburg, VA 23805 | 2006-08-04 |
| 1851330443 | Ramesh C. Agarwal | Psychiatry & Neurology | 269 Medical Park Blvd, Petersburg, VA 23805-9337 | 2006-06-06 |
| 1609831544 | Ramesh B. Koduri | Psychiatry & Neurology | 269 Medical Park Blvd, Petersburg, VA 23805-9337 | 2006-04-20 |
| 1942265509 | C. Rao Amara | Psychiatry & Neurology | 269 Medical Park Blvd, Petersburg, VA 23805-9337 | 2006-04-18 |
| 1699734517 | James W Wooldridge Jr. | Psychiatry & Neurology | 269 Medical Park Blvd, Petersburg, VA 23805-9337 | 2006-03-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134690647 | Miles Viant | Occupational Therapist | 287 E Blvd, Petersburg, VA 23805 | 2018-12-10 |
| 1245756964 | Dexter Shabazz Lett | Registered Nurse | 10543 S. Crater Rd, S. Prince George, VA 23805 | 2017-08-15 |
| 1891145876 | Taylor Enhanced Living | Counselor | 105 Holly Hill Dive, Suite A, Petersburg, VA 23805 | 2016-06-21 |
| 1700255205 | Ina Thompson | Counselor | 272 Medical Park Boulevard, Petersburg, VA 23805 | 2015-09-15 |
| 1932582541 | Valeria Edda Madrid Malo Bohorquez | Internal Medicine | 50 Medical Park Blvd Ste C, Petersburg, VA 23805 | 2015-06-30 |
| 1548642788 | Justin Andrew Phillingane | Podiatrist | 3335 S Crater Rd Ste 500, Petersburg, VA 23805 | 2015-06-24 |
| 1225417082 | Paladin Dermatology LLC | Nurse Practitioner | 44 A& B Medical Park Blvd, Petersburg, VA 23805 | 2015-05-27 |
| 1245652544 | Family Services Inc. | Health Maintenance Organization | 1045 Gustavo Lane, Petersburg, VA 23805 | 2014-01-06 |
| 1619268075 | Charlene Belangia | Massage Therapist | 3323 S. Crater Rd, Suite B, Petersburg, VA 23805 | 2011-04-20 |
| 1760709638 | Caresouth Hha Holdings of Virginia, LLC | Home Health | 34 Medical Park Boulevard, Suite G-h, Petersburg, VA 23805 | 2010-04-30 |
| Find all providers in zip 23805 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902248073 | Tanvir Iqbal | Psychiatry & Neurology | 201 S Main St Ste 3400, Danville, VA 24541-2932 | 2013-07-18 |
| 1821364043 | Michael Kubelik Heck | Psychiatry & Neurology | 691 Berkmar Cir, Charlottesville, VA 22901-1464 | 2012-04-02 |
| 1831403864 | Neel Nene | Psychiatry & Neurology | 801 N Quincy St Ste 601, Arlington, VA 22203-1729 | 2010-08-02 |
| 1295048684 | My Psychiatrist, Plc | Psychiatry & Neurology | 12359 Sunrise Valley Dr Ste 320, Herndon, VA 20191-3463 | 2010-07-14 |
| 1023257979 | Kevin Michael Williams | Psychiatry & Neurology | 3737 Seminary Rd, Alexandria, VA 22304-5202 | 2009-02-17 |
| 1881854982 | John Paul Steg | Psychiatry & Neurology | 6760 Old Mclean Village Dr, Mc Lean, VA 22101-3906 | 2008-06-11 |
| 1336343516 | Nelson Lugo | Psychiatry & Neurology | 43330 Junction Plz Ste 160, Pmb 108, Ashburn, VA 20147-3408 | 2007-06-12 |
| 1598973471 | Charles E Hall Iv | Psychiatry & Neurology | 100 Boulders Pkwy, Suite 202, Richmond, VA 23225 | 2007-05-21 |
| 1699983692 | Heather Kilbride Henig | Psychiatry & Neurology | 11490 Commerce Park Dr Ste 420, Reston, VA 20191 | 2007-05-21 |
| 1104942754 | William Louis Licamele | Psychiatry & Neurology | 6760 Old Mclean Village Dr., Mclean, VA 22101-3906 | 2007-03-22 |
| Find all providers with the same taxonomy | ||||
| City | PETERSBURG |
| Zip Code | 23805 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.