Individual provider Active NPI

Dawn Cheri Wyckoff, MD

  • Family Medicine Physician
  • MC Lean, VA
National Provider Identifier
1356328413
Registry record updated Mar 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101259076 Issued in VA
Practice address
8008 Westpark Dr
MC Lean, VA 22102-3109
Phone
(703) 287-6400
NPI assigned
Dec 29, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101259076 VA Primary

Addresses

Primary practice location

8008 Westpark Dr
MC Lean, VA 22102-3109

Mailing address

12255 Fair Lakes Pkwy
Fairfax, VA 22033-3952
Phone (808) 321-1056

Other practice location 1

12255 Fair Lakes Pkwy
Fairfax, VA 22033-3952
Phone (808) 321-1056

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170412000301 DC Practitioner - Family Practice 3274705009 Reassigns benefits to 1 organization
I20181228002504 VA Practitioner - Family Practice 3274705009 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Uniformed Services Uhs Fe Hebert School of Med, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kaiser Foundation Health Plan of the Mid Atlantic States, IncGroup PAC ID 3779495858, 1,921 clinicians

Practice addresses (Care Compare)

12255 Fair Lakes Pkwy
Fairfax, VA 22033-3952
Phone (703) 237-4800

14139 Potomac Mills Rd
Woodbridge, VA 22192-4644
Phone (703) 257-3000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc Family Medicine CurrentSince Feb 6, 2017 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Nov 5, 2018 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc Family Medicine Current Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Feb 6, 2017 Accepting new patients

Locations

2101 E Jefferson St
Ste 6
Rockville, MD 20852

2101 E Jefferson St
Ste 4EAST
Rockville, MD 20852

2101 E Jefferson St
Ste 6WPPQA
Rockville, MD 20852
Phone (301) 816-5853

1221 Mercantile Ln
Upper Marlboro, MD 20774
Phone (301) 618-5500

12255 Fair Lakes Pkwy
Fairfax, VA 22033
Phone (703) 934-5700

8008 Westpark Dr
Tysons Corner, VA 22102
Phone (703) 287-6400

14139 Potomac Mills Rd
Woodbridge, VA 22192
Phone (703) 257-3000

Organizations & group practices 4

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": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773014400000",
    "number": "1356328413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12255 FAIR LAKES PKWY",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220333952",
            "telephone_number": "808-321-1056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8008 WESTPARK DR",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221023109",
            "telephone_number": "703-287-6400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12255 Fair Lakes Pkwy",
            "address_purpose": "LOCATION",
            "city": "Fairfax",
            "state": "VA",
            "postal_code": "220333952",
            "country_code": "US",
            "telephone_number": "808-321-1056",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WYCKOFF",
        "first_name": "DAWN",
        "middle_name": "CHERI",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-29",
        "last_updated": "2026-03-09",
        "certification_date": "2026-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101259076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "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 MC Lean, VA

Sources for this page

Verify at the official NPI Registry.