Active NPI
Gracy Emmanuel Nidhiry, VA
- Pediatrics Physician
- Dumfries, VA
National Provider Identifier
1093785636
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 0101059329
- Practice address
- 3700 Fettler Park
Dumfries Health Center
Dumfries, VA 22025 - Phone
- (703) 441-7500
- Fax
- (703) 491-1413
- NPI assigned
- Jan 25, 2006
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 0101059329 | VA | Primary |
Addresses
Primary practice location
3700 Fettler Park
Dumfries Health Center
Dumfries, VA 22025
Mailing address
3700 Fettler Park
Dumfries Health Center
Dumfries, VA 22025
Phone (703) 441-7500
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138147200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1364947200000",
"number": "1093785636",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3700 FETTLER PARK",
"address_2": "DUMFRIES HEALTH CENTER",
"city": "DUMFRIES",
"state": "VA",
"postal_code": "22025",
"telephone_number": "703-441-7500",
"fax_number": "703-491-1413"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3700 FETTLER PARK",
"address_2": "DUMFRIES HEALTH CENTER",
"city": "DUMFRIES",
"state": "VA",
"postal_code": "22025",
"telephone_number": "703-441-7500",
"fax_number": "703-491-1413"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NIDHIRY",
"first_name": "GRACY",
"middle_name": "EMMANUEL",
"name_prefix": "Dr.",
"credential": "VA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-25",
"last_updated": "2013-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "VA",
"license": "0101059329",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dumfries, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.