Walid I. Fawaz, M.D.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

0101243555 Issued in VA

Practice address

207 N 4TH Ave
Hopewell, VA 23860-2503

Phone

(804) 541-0918

Fax

(804) 541-7924

NPI assigned

Jun 24, 2008

Last updated

Oct 10, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Other, 1992

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Virginia South Psychiatric and Family ServicesGroup PAC ID 3476443797, 35 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• CJW Medical Center Hospital, Richmond, VA, CCN 490112

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.72142

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

• Virginia South Psychiatric & Family Services

  • Psychiatry Physician
  • Petersburg, VA
  • NPI 1700894466
  Medicare reassignment Care Compare group NPD
• Three Rivers Treatment Center LLC

  dba Three Rivers Treatment Center

  • Psychiatric Residential Treatment Facility
  • Kenbridge, VA
  • NPI 1568827780
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Chippenham & Johnston-Willis Hospitals Inc

  dba CJW Medical Center

  • General Acute Care Hospital
  • Richmond, VA
  • NPI 1598708513
  Care Compare affiliation

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

{
    "created_epoch": "1214265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381363200000",
    "number": "1477714111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "269 MEDICAL PARK BLVD",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238059337",
            "telephone_number": "804-861-0700",
            "fax_number": "804-863-4626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 N 4TH AVE",
            "city": "HOPEWELL",
            "state": "VA",
            "postal_code": "238602503",
            "telephone_number": "804-541-0918",
            "fax_number": "804-541-7924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAWAZ",
        "first_name": "WALID",
        "middle_name": "I.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-24",
        "last_updated": "2013-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0101243555",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "VA",
            "license": "0101243555",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1477714111",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eye Surgeons of Richmond (Virginia Eye Institute)
• Ez & Reliable Transportation LLC
• Sanquisha Symone Faison, PMHNP-BC
• Family Practice Associates of Hopewell, Inc.
• Donald Devere Farr, LCSW,CSOTP
• William Paul Fernald, DDS
• Ferraro Enterprises Inc (Reliacare Family Pharmacy)
• John R Ferraro, RPH
• George F Fetko
• Kelly Fletcher, MSPT

• Child & Adolescent Psychiatry Physician in Hopewell, VA
• Providers in Hopewell, VA by specialty
• Child & Adolescent Psychiatry Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2013; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.