Active NPI
Rex Russell Vogan II, PSYD
- Clinical Psychologist
- Ashburn, VA
National Provider Identifier
1073763330
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 0810004000
- Practice address
- 44121 Harry Byrd Hwy
Suite 255
Ashburn, VA 20147-5667 - Phone
- (410) 507-3777
- NPI assigned
- Sep 23, 2008
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 0810004000 | VA | Primary |
Addresses
Primary practice location
44121 Harry Byrd Hwy
Suite 255
Ashburn, VA 20147-5667
Mailing address
44121 Harry Byrd Hwy
Suite 255
Ashburn, VA 20147-5667
Phone (410) 507-3777
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 |
|---|---|---|---|
| 0810004000 | VA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1222128000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1222128000000",
"number": "1073763330",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "44121 HARRY BYRD HWY",
"address_2": "SUITE 255",
"city": "ASHBURN",
"state": "VA",
"postal_code": "201475667",
"telephone_number": "410-507-3777"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "44121 HARRY BYRD HWY",
"address_2": "SUITE 255",
"city": "ASHBURN",
"state": "VA",
"postal_code": "201475667",
"telephone_number": "410-507-3777"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VOGAN",
"first_name": "REX",
"middle_name": "RUSSELL",
"name_prefix": "Dr.",
"name_suffix": "II",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-09-23",
"last_updated": "2008-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "VA",
"license": "0810004000",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ashburn, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.