Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Gavan W Yates, PA

Individual provider Physician Assistant · NPI 1700451655

Gavan W Yates, PA is a Physician Assistant in South Boston, Virginia. Qualified in 2021, 5 years ago. Practices with Dominion Health Medical Assoc, a 34-clinician group and accepts Medicare assignment. Licensed in Virginia.

Years since qualifying
5
Licensed in
VA
In the registry since
2021
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

See every abbreviation used in this directory →

Practice location Address checks out

2232 Wilborn Ave Ste C
South Boston, VA 24592-1662
Phone: (434) 517-3910
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 0110008467 (VA)

Record details

NPI number1700451655
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorYes
NPI enumeratedMay 24, 2021
Last updated in NPPESJuly 22, 2022
Certification dateJuly 22, 2022
Mailing address2232 Wilborn Ave Ste C, South Boston, VA 24592-1662

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Dominion Health Medical Assoc — 34 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in South Boston