Individual provider Active NPI

Eythor Bjorgvinsson, M.D.

  • Diagnostic Radiology Physician
  • Tamuning, GU
National Provider Identifier
1114365632
Registry record updated Jun 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
0101251027 Issued in VA
Practice address
633 Gov. Carlos Camacho Rd
Ste 210 Guam Medical Plaza
Tamuning, GU 96913-3195
Phone
(671) 649-1001
Fax
(671) 649-1002
NPI assigned
Jun 6, 2013
Last updated
Jun 6, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 0101251027 VA Primary

Addresses

Primary practice location

633 Gov. Carlos Camacho Rd
Ste 210 Guam Medical Plaza
Tamuning, GU 96913-3195

Mailing address

633 Gov. Carlos Camacho Rd
Ste 210 Guam Medical Plaza
Tamuning, GU 96913-3195
Phone (671) 649-1001

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101251027VAMDDiagnostic Radiology Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1370476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370476800000",
    "number": "1114365632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "633 GOV. CARLOS CAMACHO RD",
            "address_2": "STE 210 GUAM MEDICAL PLAZA",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "969133195",
            "telephone_number": "671-649-1001",
            "fax_number": "671-649-1002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "633 GOV. CARLOS CAMACHO RD",
            "address_2": "STE 210 GUAM MEDICAL PLAZA",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "969133195",
            "telephone_number": "671-649-1001",
            "fax_number": "671-649-1002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BJORGVINSSON",
        "first_name": "EYTHOR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-06",
        "last_updated": "2013-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "VA",
            "license": "0101251027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tamuning, GU

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 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.

Verify at the official NPI Registry.