SHIMEAL GORDON
NPI 1194568683
Nurse Practitioner - Gerontology in Fredericksburg, VA
About Shimeal Gordon NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SHIMEAL GORDON (NPI 1194568683) is an individual gerontology provider in Fredericksburg, Virginia, licensed in Virginia (0024193790) and active in the NPI registry since June 2024. She is enrolled in Medicare PECOS, is affiliated with Mary Washington Hospital, and is a graduate of Other (2024).
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Shimeal Gordon is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Shimeal Gordon reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Arlington, VA 22203
- Reassigned Medicare billing, Virginia enrollment
- 1,315 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Hospital Affiliations CMS Care Compare 2
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Mary Washington Hospital
Acute Care Hospitals · Fredericksburg, VASpotsylvania Regional Medical Center
Acute Care Hospitals · Fredericksburg, VAPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 22408 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
FREDERICKSBURG, VA 22408
FREDERICKSBURG, VA 22408
FREDERICKSBURG, VA 22408
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Shimeal Gordon's NPI number?
The NPI number for Shimeal Gordon is 1194568683. It was assigned to this individual provider in the NPPES registry on June 13, 2024.
Where is Shimeal Gordon located?
Shimeal Gordon practices at 9530 Cosner Dr Ste 200, Fredericksburg, VA 22408. The listed phone number is (540) 373-1331.
What is Shimeal Gordon's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.
Is Shimeal Gordon enrolled in Medicare?
Yes. Shimeal Gordon is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Shimeal Gordon's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Shimeal Gordon reassigns Medicare benefits to Privia Medical Group, LLC (Arlington, VA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Shimeal Gordon's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Shimeal Gordon affiliated with any hospitals?
According to CMS data, Shimeal Gordon is affiliated with Mary Washington Hospital and Spotsylvania Regional Medical Center.
When was this NPI record last updated?
The NPPES record for Shimeal Gordon was last updated on November 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Shimeal Gordon · NPI 1194568683
Gerontology physician in Fredericksburg, Virginia. Individual provider, active in the CMS NPPES registry since June 13, 2024.
## Identity
- **NPI:** 1194568683 (Entity type: Individual)
- **Enumerated:** June 13, 2024
- **Primary specialty:** Nurse Practitioner - Gerontology · taxonomy 363LG0600X
- **State license:** 0024193790 (Virginia)
- **Sole proprietor:** No
## Practice location
- **Address:** 9530 COSNER DR STE 200, Fredericksburg, VA 22408-7760
- **Phone:** (540) 373-1331
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Privia Medical Group, LLC (NPI 1013042480, Arlington, VA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2024
## Record status
- **NPPES last updated:** November 2, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1194568683) · Data from the CMS NPPES public registry.