Erica M Shackelford (NPI# 1902375694, PAC ID# 0244578060) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1902375694 |
| PAC ID by PECOS | 0244578060 |
| Professional Enrollment ID | I20190220001649 |
| Full Name | Erica M Shackelford |
| Organization Legal Name | VITA FAMILY MEDICINE AND MEDSPA LLC |
| Address |
540 Fort Evans Rd Suite 204 Leesburg VA 20176-3379 |
| Phone Number | 7037373500 |
| Gender | F |
| Graduation Year | 2018 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 4688962442 |
| Number of Group Practice Members | 2 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 490043 | INOVA LOUDOUN HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 540 Fort Evans Rd, Suite 204, Leesburg, VA 20176-3379 | 7037373500 | VITA FAMILY MEDICINE AND MEDSPA LLC |
| Organization Legal Name | VITA FAMILY MEDICINE AND MEDSPA LLC |
| Physicians | 2 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jennifer B Boudreau | Family Medicine | Vita Family Medicine and Medspa LLC | 540 Fort Evans Rd, Suite 204, Leesburg, VA 20176-3379 |
| Street Address |
540 FORT EVANS RD SUITE 204 |
| City | LEESBURG |
| State | VA |
| Zip | 20176-3379 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jennifer B Boudreau | Family Medicine | Vita Family Medicine and Medspa LLC | 540 Fort Evans Rd, Suite 204, Leesburg, VA 20176-3379 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kevin A Duke | Chiropractic | 19465 Deerfield Ave, Suite 108, Lansdowne, VA 20176-1702 | |
| Behnam Daghigh | Allergy/immunology | Allergy Asthma and Sinus Center PC | 19465 Deerfield Ave, Suite 101, Leesburg, VA 20176-1702 |
| Elisabeth Miller | Qualified Speech Language Pathologist | Blue Ridge Speech and Hearing Center of Loudoun County, Inc. | 19465 Deerfield Ave, Suite 201, Lansdowne, VA 20176-1703 |
| Ifeoma Anulika Ilo | Certified Nurse Midwife (cnm) | Specialty Physicians of Northern Virginia LLC | 19465 Deerfield Ave, Suite 205, Leesburg, VA 20176-1703 |
| Nurisha Shavon Jack | Certified Nurse Midwife (cnm) | Specialty Physicians of Northern Virginia LLC | 19465 Deerfield Ave, Suite 205, Leesburg, VA 20176-1703 |
| Rebekah K Hamley | Qualified Speech Language Pathologist | Blue Ridge Speech and Hearing Center of Loudoun County, Inc. | 19465 Deerfield Ave, Suite 201, Lansdowne, VA 20176-1703 |
| Kelly Wooten-pilson | Qualified Audiologist | Blue Ridge Speech and Hearing Center of Loudoun County, Inc. | 19465 Deerfield Ave, Suite 201, Lansdowne, VA 20176-1703 |
| Sara R Scott | Physical Therapy | Loudoun Medical Group PC | 19465 Deerfield Ave, Suite 208, Leesburg, VA 20176-1703 |
| Ian Wattenmaker | Orthopedic Surgery | Loudoun Medical Group PC | 19465 Deerfield Ave, Suite 207, Leesburg, VA 20176-1703 |
| Emily Frances Rooney | Qualified Audiologist | Blue Ridge Speech and Hearing Center of Loudoun County, Inc. | 19465 Deerfield Ave, Suite 201, Lansdowne, VA 20176-1703 |
| Find all physicians in zip 20176 | |||
| City | LEESBURG |
| Zip Code | 20176 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | LEESBURG + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Erica M Shackelford.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.