Dwana Rashad Shabazz, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

0101240235 Issued in VA

Practice address

12011 Lee Jackson Memorial Hwy Ste 440
Fairfax, VA 22033-3335

Phone

(703) 865-6801

NPI assigned

Jun 25, 2006

Last updated

Sep 12, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Dwana Rashad Lynch Former name

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

Specialty

Dermatology

Education

George Washington University School of Medicine, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Renascance Dermatology PC

  • Dermatology Physician
  • Fairfax, VA
  • NPI 1457796641

  DC

  Medicare reassignment NPD Authorized official
• Fair Oaks Podiatry and Sports

  • Foot & Ankle Surgery Podiatrist
  • Fairfax, VA
  • NPI 1912140310
  NPD (past)

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505174400000",
    "number": "1548296817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12011 LEE JACKSON MEMORIAL HWY SUITE 440",
            "address_2": "SUITE 303",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "22033",
            "telephone_number": "703-865-6801",
            "fax_number": "703-865-6784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12011 LEE JACKSON MEMORIAL HWY STE 440",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220333335",
            "telephone_number": "703-865-6801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHABAZZ",
        "first_name": "DWANA",
        "middle_name": "RASHAD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-25",
        "last_updated": "2017-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "VA",
            "license": "0101240235",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "VA",
            "license": "0101240235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DWANA",
            "last_name": "LYNCH",
            "middle_name": "RASHAD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Vandana Sethi, DDS
• Shauna Marie Severo, RN, BSN
• Caroline Sexson
• Amanda Seymore, MOTR/L
• Mojgan Shaafi, DDS
• Zakee Omar Shabazz, DPM
• Raafat Ali Shabti, MD
• Shaden Dental Group PLLC
• Shady Grove Reproductive Science Center PC (SGF Fairfax Procedure Center)
• Danielle A. Shafer, DO

• Dermatology Physician in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Dermatology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2017; 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.