EXCLUDEDPROVIDER
Individual Revocation

Derron M Simon

Midlothian, VA 23114

Public HHS-OIG LEIE exclusion record

Derron M Simon of Midlothian, VA is registered in the CMS NPI Registry under National Provider Identifier (NPI) 1164482980 with a primary specialty of Surgery. According to the HHS-OIG List of Excluded Individuals/Entities (LEIE), Derron M Simon is currently excluded from participation in federally funded health care programs due to license revocation, suspension, or surrender, as of February 19, 2015.

Status
Currently listed by HHS-OIG
Record type
Individual
Location
Midlothian, VA 23114
Exclusion date
February 19, 2015
Exclusion type
Revocation (1128b4)
NPI
1164482980

Record summary

Derron M Simon appears in the HHS-OIG List of Excluded Individuals/Entities (LEIE) public dataset as an individual record associated with Midlothian, Virginia. The latest imported LEIE dataset lists this record as currently excluded from participation in federally funded health care programs. The exclusion date shown in the source record is February 19, 2015, and the exclusion type is 1128b4, identified by HHS-OIG as license revocation, suspension, or surrender.

Source record

SourceHHS-OIG LEIE (public dataset)
Record typeIndividual
Current statusCurrently listed by HHS-OIG
Exclusion dateFebruary 19, 2015
Exclusion typeLicense revocation, suspension, or surrender (1128b4)
NPI1164482980
Source dataset dateMay 2026

What this exclusion type means

HHS-OIG identifies exclusion type 1128b4 as “License revocation, suspension, or surrender.” License revocation, suspension, or surrender (permissive exclusion).

This exclusion type is a statutory category used by HHS-OIG in the LEIE dataset. The category describes the legal authority associated with the exclusion record, not a separate investigation or additional reporting by Excluded Provider.

Location and provider classification

This LEIE record is associated with Midlothian, VA 23114. The listed provider category is Physician (MD, DO). The listed specialty is General Practice.

NPI Registry context

The LEIE record lists NPI 1164482980. CMS NPPES public registry data lists this NPI as an individual record with primary taxonomy Surgery (208600000X). Registered practice location: Arlington, VA. NPI enumeration date: Mar 24, 2006. NPPES status: Active. The NPI Registry lists credential: MD.

NPI Registry data is administrative provider-identification data from CMS. It does not independently verify or explain the HHS-OIG exclusion record above. Verify exclusion status directly with HHS-OIG.

Other excluded providers in Midlothian, VA

Other individuals and entities currently listed in the HHS-OIG LEIE public dataset with a Midlothian, VA address.

Stephanie Elizabeth Brown Individual Revocation
Midlothian, VA · License revocation, suspension, or surrender · Excluded Sep 2025
Janet G Cookson Individual Revocation
Midlothian, VA · License revocation, suspension, or surrender · Excluded Sep 2024
Jessica Marie Johnson Individual Program Crime
Midlothian, VA · Conviction of program-related crimes · Excluded Jul 2017
Anandababu B Chellappan Individual Revocation
Midlothian, VA · License revocation, suspension, or surrender · Excluded Feb 2016
Iris Peacoia Seldon Individual Program Crime
Midlothian, VA · Conviction of program-related crimes · Excluded Jun 2015
Daniel Chisolm Individual Revocation
Midlothian, VA · License revocation, suspension, or surrender · Excluded Jun 2012
Salah Ibrahim Adam Individual Program Crime
Midlothian, VA · Conviction of program-related crimes · Excluded Sep 2006
Tina Marie Brown Individual Revocation
Midlothian, VA · License revocation, suspension, or surrender · Excluded Mar 2004

See all 17 excluded providers in Midlothian →

How to verify this record

This page is a public-record summary and should be treated as a possible LEIE match, not final identity verification. To verify the record, use the official HHS-OIG LEIE search and compare available identifying information through the official process. Name, location, provider category, specialty, exclusion date, and NPI should be treated as matching clues rather than final proof of identity.

What this page does not include

This page summarizes the HHS-OIG LEIE public dataset only. It does not search state Medicaid exclusion lists, state licensing-board actions, court records, malpractice records, employment history, civil lawsuits, or non-public investigations.

Verify with HHS-OIG Remove / correct this record

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