The Clinical Skin Center of Northern Virginia PLLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

0101049818 Issued in VA

Legal business name

THE CLINICAL SKIN CENTER OF NORTHERN VIRGINIA PLLC

Doing business as

Clinical Skin Center

Practice address

3700 Joseph Siewick Dr
Suite 404
Fairfax, VA 22033-1744

Phone

(703) 620-8900

Fax

(703) 620-2288

NPI assigned

Aug 9, 2005

Last updated

Jan 14, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mitchell E. Stashower, M.D.NPI 1801894290

Title

Owner

Phone

(703) 620-8900

Specialties & licenses 1

Addresses

Other names 1

• Clinical Skin Center Doing business as

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mitchell E. Stashower, M.D.

  • Specialist
  • Fairfax, VA
  • NPI 1801894290

  DC

  Medicare reassignment Care Compare group NPD Authorized official
• Andrea Morris, MD

  • Dermatology Physician
  • Fairfax, VA
  • NPI 1912161209

  DC, Single Specialty

  Medicare reassignment Care Compare group NPD
• Jeffrey F Scott, MD

  • MOHS-Micrographic Surgery Physician
  • Fairfax, VA
  • NPI 1174960306

  DC

  Medicare reassignment Care Compare group NPD
• Kathy Diep Ngoc Tieu, M.D.

  • Dermatology Physician
  • Fairfax, VA
  • NPI 1811973951

  DC

  Medicare reassignment Care Compare group NPD
• Emily Thai

  • Physician Assistant
  • Fairfax, VA
  • NPI 1457083230

  DC

  Medicare reassignment Care Compare group
• Chloe Eunjung Yun, PA-C

  • Medical Physician Assistant
  • Fairfax, VA
  • NPI 1558042663

  DC

  Medicare reassignment Care Compare group
• Kaitlyn Burns

  • Physician Assistant
  • Leesburg, VA
  • NPI 1164949665

  DC

  Medicare reassignment

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294963200000",
    "number": "1700887387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 JOSEPH SIEWICK DR",
            "address_2": "SUITE 404",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220331744",
            "telephone_number": "703-620-8900",
            "fax_number": "703-620-2288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 JOSEPH SIEWICK DR",
            "address_2": "SUITE 404",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220331744",
            "telephone_number": "703-620-8900",
            "fax_number": "703-620-2288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CLINICAL SKIN CENTER OF NORTHERN VIRGINIA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-09",
        "last_updated": "2011-01-14",
        "status": "A",
        "authorized_official_last_name": "STASHOWER",
        "authorized_official_first_name": "MITCHELL",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "703-620-8900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "VA",
            "license": "0101049818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clinical Skin Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Specialist in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Specialist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.