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

Mia Jo Taveroni

Individual provider Physician Assistant · NPI 1205793502

Mia Jo Taveroni is a Physician Assistant in Fredericksburg, Virginia. Works from 4 locations. Licensed in Virginia.

Licensed in
VA
In the registry since
2026
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

10 Stafford Lakes Pkwy Ste 102
Fredericksburg, VA 22406-7305
Phone: (540) 741-6982
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

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

Additional practice locations (3)

  • 648 Mariann Pl, Township Of Washington, NJ 07676-3934 — (201) 663-0933
  • 11131 Journal Pkwy Ste A, King George, VA 22485-3468 — (540) 741-6982
  • 955 Wonder Rd Ste C, Stafford, VA 22554-7798 — (540) 741-7890

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 0110011893 (VA)

Record details

NPI number1205793502
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJanuary 7, 2026
Last updated in NPPESJune 8, 2026
Certification dateJune 8, 2026
Mailing address1340 Central Park Blvd Ste 100, Fredericksburg, VA 22401-4940

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2026 (0 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

Other providers in Fredericksburg