Shelby Lawanson

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

C0010154 Issued in MD

Practice address

4225 Altamont PL Ste 3
White Plains, MD 20695-3064

Phone

(301) 843-1600

NPI assigned

Aug 18, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

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

Specialty

Physician Assistant

Education

Duke University School of Medicine, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Integrated Dermatology of White Plains LLCGroup PAC ID 5496037848, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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 and National Provider Directory roles.

• Integrated Dermatology of White Plains, LLC

  • Dermatology Physician
  • White Plains, MD
  • NPI 1225581879
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1755475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758585600000",
    "number": "1700763323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4225 ALTAMONT PL STE 3",
            "city": "WHITE PLAINS",
            "state": "MD",
            "postal_code": "206953064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4225 ALTAMONT PL STE 3",
            "city": "WHITE PLAINS",
            "state": "MD",
            "postal_code": "206953064",
            "telephone_number": "301-843-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWANSON",
        "first_name": "SHELBY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-18",
        "last_updated": "2025-09-23",
        "certification_date": "2025-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0010154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edith Kratzer, RN
• Kssential Nutrition LLC
• Adenike Kupolati, RPH
• Meghan A Lainoff, PA-C
• Kimberly Destefano Larsen, MD
• Eileen Leahy, NP
• Soo Yun Stacy Lee, D.D.S.
• Shanice Renee Levy
• Ti'Aesha K Lewis
• LHG Global, Intl., Inc.

• Physician Assistant in White Plains, MD
• Providers in White Plains, MD by specialty
• Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2025; 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.