Individual provider Active NPI

Daniel Shook, M.D.

  • Diagnostic Radiology Physician
  • Purcellville, VA
National Provider Identifier
1386823748
Registry record updated May 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
0101052811 Issued in VA
Practice address
126 Ivy Hills Ter
Purcellville, VA 20132-6144
Phone
(703) 544-7088
NPI assigned
Nov 1, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 0101052811 VA Primary

Addresses

Primary practice location

126 Ivy Hills Ter
Purcellville, VA 20132-6144

Mailing address

PO Box 2550
Purcellville, VA 20134-4550

Other identifiers 1

IdentifierTypeStateIssuer
1386823748MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101052811VAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vision Radiology PC Diagnostic Radiology Past Accepting new patients

Organizations & group practices 1

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": "1193875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400284800000",
    "number": "1386823748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2550",
            "city": "PURCELLVILLE",
            "state": "VA",
            "postal_code": "201344550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 IVY HILLS TER",
            "city": "PURCELLVILLE",
            "state": "VA",
            "postal_code": "201326144",
            "telephone_number": "703-544-7088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOOK",
        "first_name": "DANIEL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-01",
        "last_updated": "2014-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "VA",
            "license": "0101052811",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1386823748",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Purcellville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2014; 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.