Individual provider Active NPI

Iris Jo-Shi, D.O.

  • Pediatric Gastroenterology Physician
  • Fairfax, VA
National Provider Identifier
1528485695
Registry record updated Nov 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
0102206212 Issued in VA
Practice address
3023 Hamaker CT Ste 600
Fairfax, VA 22031-2241
Phone
(703) 876-2788
Fax
(703) 839-8764
NPI assigned
Mar 26, 2014
Last updated
Nov 19, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Pediatric Gastroenterology Physician 2080P0206X 0102206212 VA Primary

Addresses

Primary practice location

3023 Hamaker CT Ste 600
Fairfax, VA 22031-2241

Mailing address

3023 Hamaker CT Ste 600
Fairfax, VA 22031-2241
Phone (703) 876-2788

Other practice location 1

920 Madison Ave Ste 447
Memphis, TN 38103-3438
Phone (901) 287-6756

Other names 1

  • Iris Jo Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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

Enrollment IDStateProvider typePAC IDDetails
I20210331001171 DC Practitioner - GastroenterologyPractitioner - Pediatric Medicine 5395012652 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0102206212VAMDPediatric Gastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Hospital CurrentSince Mar 23, 2021 Accepting new patients
Children's Hospital CurrentSince Mar 23, 2021 Accepting new patients
Children's Hospital Current Accepting new patients
Inova Health Care Services - Pathology Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

111 Michigan Ave NW
Washington, DC 20010
Phone (202) 476-3670

3023 Hamaker Ct
Ste 400
Fairfax, VA 22031
Phone (571) 226-8380

3023 Hamaker Ct
Ste 600
Fairfax, VA 22031

Interoperability endpoints

  • Direct secure messaging: ijoshi750664@soc.inova.org

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1395792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605744000000",
    "number": "1528485695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3023 HAMAKER CT STE 600",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220312241",
            "telephone_number": "703-876-2788",
            "fax_number": "703-839-8764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3023 HAMAKER CT STE 600",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220312241",
            "telephone_number": "703-876-2788",
            "fax_number": "703-839-8764"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "920 Madison Ave Ste 447",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381033438",
            "country_code": "US",
            "telephone_number": "901-287-6756",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JO-SHI",
        "first_name": "IRIS",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-26",
        "last_updated": "2020-11-19",
        "certification_date": "2020-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "VA",
            "license": "0102206212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "IRIS",
            "last_name": "JO",
            "credential": "DO",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.