Active NPI
Shelly-Ann James, MD
- Obstetrics Physician
- Fairfax, VA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics Physician
- License
- 0101248442
- Practice address
- 12255 Fair Lakes Pkwy
Fairfax, VA 22033-3952 - Phone
- (540) 720-7340
- NPI assigned
- May 1, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics Physician | 207VX0000X | 0101248442 | VA | Primary |
Addresses
Primary practice location
12255 Fair Lakes Pkwy
Fairfax, VA 22033-3952
Mailing address
111 College Rd
Apt 4F
Selden, NY 11784-2800
Phone (631) 946-6086
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways | Health Information Exchange (HIE) | |
| SOAP URL | https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA, DC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101248442 | VA | MD | Obstetrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kaiser Foundation Health Plan of the Mid Atlantic States, Inc | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of the Mid Atlantic States, Inc | Multi-Specialty | Current | Accepting new patients |
| Kaiser Foundation Health Plan of the Mid Atlantic States, Inc | Current | Accepting new patients |
Locations
2101 E Jefferson St
#4
Rockville, MD 20852
1221 Mercantile Ln
Upper Marlboro, MD 20774
Phone (301) 618-5500
12255 Fair Lakes Pkwy
Fairfax, VA 22033
Phone (703) 934-5700
125 Hospital Center Blvd
Ste 221
Stafford, VA 22554
Phone (540) 741-5501
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.
-
- Health Maintenance Organization
- Annapolis, MD
- NPI 1952461816
DC, Multi-Specialty
-
- Health Maintenance Organization
- MC Lean, VA
- NPI 1376815472
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Rockville, MD
- NPI 1962108753
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624924800000",
"number": "1336315167",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 COLLEGE RD",
"address_2": "APT 4F",
"city": "SELDEN",
"state": "NY",
"postal_code": "117842800",
"telephone_number": "631-946-6086"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12255 FAIR LAKES PKWY",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220333952",
"telephone_number": "540-720-7340"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAMES",
"first_name": "SHELLY-ANN",
"name_prefix": "Miss",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-05-01",
"last_updated": "2021-06-29",
"certification_date": "2021-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "207VX0000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Obstetrics & Gynecology, Obstetrics",
"state": "VA",
"license": "0101248442",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways",
"affiliation": "N",
"endpointDescription": "carequality",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "12255 Fair Lakes Pkwy",
"city": "Fairfax",
"state": "VA",
"country_code": "US",
"postal_code": "220333952",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways",
"affiliation": "N",
"endpointDescription": "carequality",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "12255 Fair Lakes Pkwy",
"city": "Fairfax",
"state": "VA",
"country_code": "US",
"postal_code": "220333952",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Fairfax, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.