Shiloh Family Medicine PC

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

0101050807 Issued in VA

Legal business name

SHILOH FAMILY MEDICINE PC

Practice address

5249 Duke St
Suite 102
Alexandria, VA 22304-2926

Phone

(703) 823-3660

Fax

(703) 823-2210

NPI assigned

Oct 18, 2006

Last updated

Aug 22, 2020By 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. Bradley Richard Ware, M.D.NPI 1417910746

Title

President/Ceo

Phone

(703) 823-3660

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Locations

Practitioners 1

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.

• Bradley Richard Ware, M.D.

  • Family Medicine Physician
  • Alexandria, VA
  • NPI 1417910746

  DC

  Medicare reassignment Authorized official

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1750462735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5249 DUKE ST",
            "address_2": "SUITE 102",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223042926",
            "telephone_number": "703-823-3660",
            "fax_number": "703-823-2210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5249 DUKE ST",
            "address_2": "SUITE 102",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223042926",
            "telephone_number": "703-823-3660",
            "fax_number": "703-823-2210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHILOH FAMILY MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WARE",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "703-823-3660",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "VA",
            "license": "0101050807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jinal Sheth, MD
• Sonal Sheth, DPT
• Hailing Shi
• Alexandra Shields, PT, DPT
• John Joseph Shigo Jr., M.D.
• Eyerusalem Shimeles
• Irene Shin, DDS
• Michelle Mihee Shin
• Leon G Shingledecker, DPM
• Dana Taylor Shively, MD

• Preferred Provider Organization in Alexandria, VA
• Providers in Alexandria, VA by specialty
• Preferred Provider Organization in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.