Active NPI
Peter Obeng
- Driver
- Woodbridge, VA
National Provider Identifier
1003310202
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Driver
- License
- A61315630
- Practice address
- 4390 Welsh LN Apt 11
Woodbridge, VA 22193-5667 - Phone
- (571) 477-8936
- NPI assigned
- Mar 21, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | A61315630 | VA | Primary |
Addresses
Primary practice location
4390 Welsh LN Apt 11
Woodbridge, VA 22193-5667
Mailing address
4390 Welsh LN Apt 11
Woodbridge, VA 22193-5667
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1044 | Other | VA | CONTRACT CARRIER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A61315630 | VA | MD | Driver |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1521590400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521590400000",
"number": "1003310202",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4390 WELSH LN APT 11",
"city": "WOODBRIDGE",
"state": "VA",
"postal_code": "221935667"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4390 WELSH LN APT 11",
"city": "WOODBRIDGE",
"state": "VA",
"postal_code": "221935667",
"telephone_number": "571-477-8936"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OBENG",
"first_name": "PETER",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-03-21",
"last_updated": "2018-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "172A00000X",
"taxonomy_group": "",
"desc": "Driver",
"state": "VA",
"license": "A61315630",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CONTRACT CARRIER",
"identifier": "1044",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Woodbridge, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.