Shae Eguchi, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0024189189 Issued in VA

Practice address

PO Box 151071
Alexandria, VA 22315-1071

Phone

(703) 540-0068

NPI assigned

Jan 25, 2024

Reactivated

Jun 12, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA, CA2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Easy Health Medical Solutions PC

  • Nurse Practitioner
  • Fulton, MD
  • NPI 1972179141

  CA

  Medicare reassignment NPD
• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487

  VA

  Medicare reassignment NPD

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

{
    "created_epoch": "1706140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718150400000",
    "number": "1356103303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 151071",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223151071",
            "telephone_number": "703-540-0068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 151071",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223151071",
            "telephone_number": "703-540-0068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EGUCHI",
        "first_name": "SHAE",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-25",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "deactivation_date": "2024-03-16",
        "reactivation_date": "2024-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024189189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deshana Edwards
• Tiffiny R Edwards, LCSW
• Tyler Decarlo Edwards
• Viola Edwards
• Brittany D Egan, MSW, LICSW, CCTP
• Ehc Therapeutic Services LLC
• Jane Ehle, PA-C
• Natalie Mary Ehredt
• Amy W Eichelberger, AG-ACNP
• Eiland Behavioral Medicine, PLLC

• Family Nurse Practitioner in Alexandria, VA
• Providers in Alexandria, VA by specialty
• Family Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2024; 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.

Verify at the official NPI Registry.