Active NPI
Annika Kezman
- Athletic Trainer
- Virginia Beach, VA
National Provider Identifier
1093389827
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 4024 Glen Rd
Virginia Beach, VA 23452-2602 - Phone
- (757) 537-5114
- NPI assigned
- May 17, 2021
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | Primary |
Addresses
Primary practice location
4024 Glen Rd
Virginia Beach, VA 23452-2602
Mailing address
4024 Glen Rd
Virginia Beach, VA 23452-2602
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| HID174M53590 | Other | VA | ANTHEM BLUE CROSS |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | laptop |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1621209600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621209600000",
"number": "1093389827",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4024 GLEN RD",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234522602"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4024 GLEN RD",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234522602",
"telephone_number": "757-537-5114"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEZMAN",
"first_name": "ANNIKA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-05-17",
"last_updated": "2021-05-17",
"certification_date": "2021-05-17",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BLUE CROSS",
"identifier": "HID174M53590",
"state": "VA"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "laptop",
"affiliation": "N",
"address_1": "4024 Glen Rd",
"city": "Virginia Beach",
"state": "VA",
"country_code": "US",
"postal_code": "234522602",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Virginia Beach, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.