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

Jared Todd Brizendine, PA

Individual provider Physician Assistant · NPI 1407472863

Jared Todd Brizendine, PA is a Physician Assistant in Charlottesville, Virginia. Qualified in 2019, 7 years ago. Practices with Kootenai Health Inc, a 394-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Idaho and Virginia.

Years since qualifying
7
Licensed in
ID, VA
In the registry since
2020
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

1215 Lee St
Charlottesville, VA 22908-0816
Phone: (434) 924-9055
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 700 W Ironwood Dr Ste 320, Coeur D Alene, ID 83814-4485 — (208) 625-5250

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 0110007130 (VA)
Physician Assistant Taxonomy 363A00000X · Licence PA-2436 (ID)

Record details

NPI number1407472863
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorYes
NPI enumeratedJune 22, 2020
Last updated in NPPESJuly 22, 2025
Certification dateJuly 22, 2025
Mailing addressPo Box 801444, Charlottesville, VA 22908-0001

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Kootenai Health Inc — 394 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations4 on file with Medicare

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