Individual provider Active NPI

Katie Shen, DNP, NP

  • Women's Health Nurse Practitioner
  • Reston, VA
National Provider Identifier
1629656749
Registry record updated Mar 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
0024195210 Issued in VA
Practice address
1850 Town Center Pkwy Ste 258
Reston, VA 20190-3300
Phone
(571) 774-4584
Fax
(703) 977-1630
NPI assigned
Mar 30, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LW0102X 0024195210 VA Primary
Ambulatory Women's Health Care Registered Nurse 163WW0101X 0001306611 VA

Addresses

Primary practice location

1850 Town Center Pkwy Ste 258
Reston, VA 20190-3300

Mailing address

1850 Town Center Pkwy Ste 258
Reston, VA 20190-3300
Phone (571) 774-4584

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260214000025 VA Practitioner - Nurse Practitioner 8729568266 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

200 W Martin Luther King Blvd
Suite 1068
Chattanooga, TN 37402-2560

PO Box
Suite 10045
Atlanta, GA 30384-0445

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0001306611VAMDAmbulatory Women's Health Care Registered Nurse
0024195210VAMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatrix Medical Group of the Mid-Atlantic PC Single Specialty CurrentSince Jan 4, 2026 Accepting new patients

Locations

44035 Riverside Pkwy
Ste 345
Leesburg, VA 20176
Phone (703) 435-1454

1850 Town Center Pkwy
Ste 258
Reston, VA 20190
Phone (703) 435-1454

24430 Stone Springs Blvd
Ste 345
Sterling, VA 20166
Phone (540) 993-4294

1840 Amherst St
Winchester, VA 22601
Phone (540) 536-8700

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": "1617062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774396800000",
    "number": "1629656749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 TOWN CENTER PKWY STE 258",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201903300",
            "telephone_number": "571-774-4584",
            "fax_number": "703-977-1630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 TOWN CENTER PKWY STE 258",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201903300",
            "telephone_number": "571-774-4584",
            "fax_number": "703-977-1630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEN",
        "first_name": "KATIE",
        "credential": "DNP, NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-30",
        "last_updated": "2026-03-25",
        "certification_date": "2026-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "VA",
            "license": "0024195210",
            "primary": true
        },
        {
            "code": "163WW0101X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Women's Health Care, Ambulatory",
            "state": "VA",
            "license": "0001306611",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reston, VA

Sources for this page

Verify at the official NPI Registry.