Individual provider Active NPI

Stephanie Shenk Bailey, PA-C

  • Physician Assistant
  • Winchester, VA
National Provider Identifier
1184961385
Registry record updated Jan 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110004108 Issued in VA
Practice address
190 Campus Blvd Ste 400
Winchester, VA 22601-2872
Phone
(540) 667-1727
Fax
(540) 722-3373
NPI assigned
Jan 8, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110004108 VA Primary

Addresses

Primary practice location

190 Campus Blvd Ste 400
Winchester, VA 22601-2872

Mailing address

190 Campus Blvd Ste 400
Winchester, VA 22601-2872
Phone (540) 667-1727

Other names 1

  • Stephanie Danielle Shenk Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130212000014 VA Practitioner - Physician Assistant 2567616998 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0110004108VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Regional Enterprises, Inc CurrentSince Jul 28, 2019 Accepting new patients
Winchester Pediatric Clinic PC Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

607 E Jubal Early Dr
Winchester, VA 22601
Phone (540) 536-2232

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1357603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705536000000",
    "number": "1184961385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 CAMPUS BLVD STE 400",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226012872",
            "telephone_number": "540-667-1727",
            "fax_number": "540-722-3373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 CAMPUS BLVD STE 400",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226012872",
            "telephone_number": "540-667-1727",
            "fax_number": "540-722-3373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "STEPHANIE",
        "middle_name": "SHENK",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-08",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110004108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "SHENK",
            "middle_name": "DANIELLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Winchester, VA

Sources for this page

Verify at the official NPI Registry.