Dr Shaquilla Vazquez Clark, DNP MSN CRNP FNP-BC - Medicare Nurse Practitioner in Fairfax, VA

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Dr Shaquilla Vazquez Clark, DNP MSN CRNP FNP-BC is a medicare enrolled "Nurse Practitioner - Family" in Fairfax, Virginia. She graduated from nursing school in 2023 and has 2 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Care Anywhere Pc, Ennoble Hc Dmv Llc, Care Anywhere Pc, Ennoble Hc Dmv Llc, Care Anywhere Pc, Ennoble Hc Dmv Llc and her current practice location is 11166 Fairfax Blvd, Ste 500 #1293, Fairfax, Virginia. You can reach out to her office (for appointments etc.) via phone at (703) 270-1010.

Dr Shaquilla Vazquez Clark is licensed to practice in Maryland (license number R193829) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1538869789.

Contact Information

Dr Shaquilla Vazquez Clark, DNP MSN CRNP FNP-BC
11166 Fairfax Blvd, Ste 500 #1293,
Fairfax, VA 22030
(703) 270-1010
(410) 220-8162

Map and Direction




Provider's Profile

Full NameDr Shaquilla Vazquez Clark
GenderFemale
SpecialityNurse Practitioner
Experience2 Years
Location11166 Fairfax Blvd, Fairfax, Virginia
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Dr Shaquilla Vazquez Clark graduated from nursing school in 2023
  NPI Data:
  • NPI Number: 1538869789
  • Provider Enumeration Date: 03/07/2023
  • Last Update Date: 12/13/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 1052757945
  • Enrollment ID: I20240314000206

Medical Identifiers

Medical identifiers for Dr Shaquilla Vazquez Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1538869789NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family 1178967 (Texas)Secondary
363LF0000XNurse Practitioner - Family 4027887 (Kentucky)Secondary
363LF0000XNurse Practitioner - Family APRN.CNP.0036121 (Ohio)Secondary
363LF0000XNurse Practitioner - Family 0024189531 (Virginia)Secondary
363LF0000XNurse Practitioner - Family R193829 (Maryland)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Bayada Home Health, IncTowson, MDHome health agency
Caregivers Home Health Services, IncFalls church, VAHome health agency
Healing Home Healthcare IncManassas, VAHome health agency
Hospice Of The ChesapeakePasadena, MDHospice

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Care Anywhere Pc29619305083
Ennoble Hc Dmv Llc903251792580
Care Anywhere Pc29619305083
Ennoble Hc Dmv Llc903251792580
Care Anywhere Pc29619305083
Ennoble Hc Dmv Llc903251792580

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Shaquilla Vazquez Clark allows following entities to bill medicare on her behalf.
Entity NameEnnoble Hc Dmv Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1104492115
PECOS PAC ID: 9032517925
Enrollment ID: O20211007000017
Entity NameCare Anywhere Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1144040817
PECOS PAC ID: 2961930508
Enrollment ID: O20250314002294

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Shaquilla Vazquez Clark is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Shaquilla Vazquez Clark, DNP MSN CRNP FNP-BC
11166 Fairfax Blvd, Ste 500 #1293,
Fairfax, VA 22030-2307

Ph: (703) 270-1010		Dr Shaquilla Vazquez Clark, DNP MSN CRNP FNP-BC
11166 Fairfax Blvd, Ste 500 #1293,
Fairfax, VA 22030

Ph: (703) 270-1010

Reviews and Comments


Nurse Practitioner Nurses in Fairfax, VA

Lindsey Stanton, CRNP
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Medicare: Accepting Medicare Assignments
Practice Location: 10530 Rosehaven St Ste 100, Fairfax, VA 22030
Phone: 703-938-0363    Fax: 703-938-8653
Hala D Mata,
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Practice Location: 3053 Nutley St, Fairfax, VA 22031
Phone: 703-560-4852    
Calvin Layne Iii, PMHNP-BC
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Practice Location: 10304 Eaton Pl Ste 100, Fairfax, VA 22030
Phone: 571-463-8620    Fax: 571-999-7549
Jenni Jeanette Lorene Barnhizer, RN, FNP
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Medicare: Accepting Medicare Assignments
Practice Location: 3580 Joseph Siewick Dr Ste 205, Fairfax, VA 22033
Phone: 703-620-3211    Fax: 703-620-3215
Natalia Castro, FNP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 12817 Hamlet Hill Way, Fairfax, VA 22030
Phone: 703-963-9033    
Erin Rudiak, MSN, APRN, FNP-C
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 9401 Route 29, Fairfax, VA 22031
Phone: 703-383-4836    
Josephine Pangan Bolivar-kerns, NP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 9299 Tower Side Dr Apt 438, Fairfax, VA 22031
Phone: 414-939-6346    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.