Individual provider Active NPI

Seyedeh Maryam Madani

  • Lactation Consultant (Non-RN)
  • Reston, VA
National Provider Identifier
1164970463
Registry record updated Sep 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Non-RN)Taxonomy code 174N00000X
License
311-78094 Issued in ZZ
Practice address
2404 Earlsgate CT
Reston, VA 20191-1608
Phone
(202) 769-8689
NPI assigned
Sep 14, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 0001265636 VA
Lactation Consultant (Non-RN) 174N00000X 311-78094 ZZ Primary

Addresses

Primary practice location

2404 Earlsgate CT
Reston, VA 20191-1608

Mailing address

2404 Earlsgate CT
Reston, VA 20191-1608
Phone (202) 769-8689

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

LicenseStateTypeSpecialty
0001265636VAMDRegistered Nurse
311-78094ZZMDLactation Consultant (Non-RN)

NPI Registry JSON

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

{
    "created_epoch": "1473811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473811200000",
    "number": "1164970463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2404 EARLSGATE CT",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201911608",
            "telephone_number": "202-769-8689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2404 EARLSGATE CT",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201911608",
            "telephone_number": "202-769-8689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADANI",
        "first_name": "SEYEDEH MARYAM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-14",
        "last_updated": "2016-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001265636",
            "primary": false
        },
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": "ZZ",
            "license": "311-78094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reston, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2016; 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.