Wan Shin, M.D.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

0101030663 Issued in VA

Practice address

300 Park Hill Dr
Fredericksburg, VA 22401-3387

Phone

(540) 361-7641

Fax

(540) 361-1246

NPI assigned

Aug 3, 2006

Last updated

Mar 21, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Wan Shin MD PC

  • Physical Medicine & Rehabilitation Physician
  • Falls Church, VA
  • NPI 1902075161
  NPD (past) Authorized official
• Pratt Medical Center LTD

  dba Pratt Healthcare Laboratory

  • Clinical Medical Laboratory
  • Fredericksburg, VA
  • NPI 1003840950
  NPD (past)
• Pratt Medical Center LTD

  dba Pratt Healthcare

  • Family Medicine Physician
  • Fredericksburg, VA
  • NPI 1316973555
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332288000000",
    "number": "1073521340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1460",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224021460",
            "telephone_number": "540-786-2100",
            "fax_number": "540-786-0677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PARK HILL DR",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224013387",
            "telephone_number": "540-361-7641",
            "fax_number": "540-361-1246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIN",
        "first_name": "WAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2012-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "VA",
            "license": "0101030663",
            "primary": true
        },
        {
            "code": "2081P0004X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine",
            "state": "VA",
            "license": "0101030663",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "VA",
            "license": "0101030663",
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "VA",
            "license": "0101030663",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1073521340",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006841643",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Delphine Ekom Shey
• Erin Hoesly Shiben, RBT
• Justin Cordell Shields, M.D.
• Kent Shiffert, PA
• Shiftless Wanderer LLC
• Hasnain Mohammad Shinwari
• Zachary Ryan Shipe
• Jessica Nichole Shipman
• Randall Shipp, CMT
• Debra Marie Shirt, SLP

• Physical Medicine & Rehabilitation Physician in Fredericksburg, VA
• Providers in Fredericksburg, VA by specialty
• Physical Medicine & Rehabilitation Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.