Individual provider Active NPI

Laura Stephens, PA-C

  • Physician Assistant
  • Reston, VA
National Provider Identifier
1871002782
Registry record updated Feb 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110-005919 Issued in VA
Practice address
11484 Washington PLZ W
Reston, VA 20190-4344
Phone
(540) 536-5500
Fax
(703) 443-2000
NPI assigned
Sep 22, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110-005919 VA Primary

Addresses

Primary practice location

11484 Washington PLZ W
Reston, VA 20190-4344

Mailing address

310 Watermill Run
Newport News, VA 23606-1251
Phone (757) 319-2554

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC, MD3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20180108001940 VA Practitioner - Physician Assistant 9638438120 Reassigns benefits to 2 organizations
I20190821002470 DC Practitioner - Physician Assistant 9638438120 Reassigns benefits to 2 organizations
I20230817003554 MD Practitioner - Physician Assistant 9638438120 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Skin PCGroup PAC ID 0648226845, 4 clinicians

Practice addresses (Care Compare)

1800 Town Ctr Dr
Suite 212
Reston, VA 20190-3238
Phone (703) 766-2220

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0110-005919VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Urgent Care, LLC CurrentSince Jul 30, 2023 Accepting new patients
Loudoun Community Health Center CurrentSince Mar 1, 2020 Accepting new patients
Medstar Urgent Care LLC CurrentSince Jul 30, 2023 Accepting new patients
Valley Physician Enterprise, Inc CurrentSince Oct 30, 2017 Accepting new patients
Valley Physician Enterprise, Inc. CurrentSince Oct 30, 2017 Accepting new patients

Locations

3007 Tilden St NW
Ste 5N
Washington, DC 20008

6317 York Rd
Baltimore, MD 21212
Phone (443) 777-6890

3064 Waldorf Market Pl
Waldorf, MD 20603
Phone (301) 932-5960

11915 Georgia Ave
Wheaton, MD 20902
Phone (301) 942-4505

1000 N Shenandoah Ave
Front Royal, VA 22630
Phone (540) 636-0300

163 Fort Evans Rd NE
Leesburg, VA 20176
Phone (703) 433-2000

11484 Washington Plz W
Ste 300
Reston, VA 20190
Phone (703) 689-2180

611 E Jubal Early Dr
Winchester, VA 22601
Phone (540) 536-5500

Organizations & group practices 8

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": "1506038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582848000000",
    "number": "1871002782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 WATERMILL RUN",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236061251",
            "telephone_number": "757-319-2554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11484 WASHINGTON PLZ W",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201904344",
            "telephone_number": "540-536-5500",
            "fax_number": "703-443-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENS",
        "first_name": "LAURA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-22",
        "last_updated": "2020-02-28",
        "certification_date": "2020-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110-005919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reston, VA

Sources for this page

Verify at the official NPI Registry.