Shansa Gaddam, MD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

0116039839 Issued in VA

Practice address

Inova Fairfax Medical Campus Gme Dept of Medicine
3300 Gallows Road
Falls Church, VA 22042

Phone

(703) 776-3582

NPI assigned

Jul 3, 2024

Last updated

Jul 3, 2024By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1719964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1922844463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "INOVA FAIRFAX MEDICAL CAMPUS GME DEPT OF MEDICINE",
            "address_2": "3300 GALLOWS ROAD",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "22042",
            "telephone_number": "703-776-3582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "INOVA FAIRFAX MEDICAL CAMPUS GME DEPT OF MEDICINE",
            "address_2": "3300 GALLOWS ROAD",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "22042",
            "telephone_number": "703-776-3582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GADDAM",
        "first_name": "SHANSA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-03",
        "last_updated": "2024-07-03",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VA",
            "license": "0116039839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Student in an Organized Health Care Education/Training Program in Falls Church, VA
• Providers in Falls Church, VA by specialty
• Student in an Organized Health Care Education/Training Program in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.