Erica Shackelford, MSN, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0024176969 Issued in VA

Practice address

540 Fort Evans Rd Ste 204
Leesburg, VA 20176-3379

Phone

(703) 737-3500

Fax

(703) 737-3550

NPI assigned

Nov 26, 2018

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 VA, DC2 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 2

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Virginia Internal Medicine IncGroup PAC ID 4082869250, 101 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

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.

• Virginia Internal Medicine Inc

  • Internal Medicine Physician
  • Ashburn, VA
  • NPI 1740525245

  DC

  Medicare reassignment Care Compare group NPD
• Vita Family Medicine and Medspa LLC

  • Family Medicine Physician
  • Leesburg, VA
  • NPI 1730532359
  Medicare reassignment NPD
• Pai Participant 1 LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Chillicothe, OH
  • NPI 1093371312

  DC, VA

  Medicare reassignment NPD
• Provider Partners Care Management LP

  • Nurse Practitioner
  • Columbia, MD
  • NPI 1013348028

  DC, VA

  Medicare reassignment NPD
• Privia Medical Group, LLC

  • Internal Medicine Physician
  • Arlington, VA
  • NPI 1013042480
  Medicare reassignment

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

{
    "created_epoch": "1543190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543190400000",
    "number": "1902375694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 FORT EVANS RD STE 204",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201763379",
            "telephone_number": "703-737-3500",
            "fax_number": "703-737-3550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 FORT EVANS RD STE 204",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201763379",
            "telephone_number": "703-737-3500",
            "fax_number": "703-737-3550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHACKELFORD",
        "first_name": "ERICA",
        "credential": "MSN, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-26",
        "last_updated": "2018-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024176969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Prathima P. Setty, M.D.
• Alyson R Severino, ACNP
• Jennifer Huaman Sevillano, LCSW
• Tara Culbreth Seward, PSY.D.
• Saeedeh Jawad Seyyed, FNP-BC
• Guadalupe C. Shafer, FNP
• Aabha A Shah, MD
• Deepa Malpani Shah, MD
• Mehul Jitendra Shah, DPM
• Shahla Ranjbar, DMD, PLC

• Family Nurse Practitioner in Leesburg, VA
• Providers in Leesburg, VA by specialty
• Family Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2018; 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.