Nicole S Vetere, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

D0064079 Issued in MD

Practice address

9901 Medical Center Drive
Shady Grove Adventist Hospital
Rockville, MD 20878

Phone

(240) 826-7550

Fax

(240) 364-9020

NPI assigned

May 22, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Nicole S Evancich Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482278400000",
    "number": "1205880358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9901 MEDICAL CENTER DRIVE",
            "address_2": "SHADY GROVE ADVENTIST HOSPITAL ATTN: MEP",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "20878",
            "telephone_number": "240-826-7550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9901 MEDICAL CENTER DRIVE",
            "address_2": "SHADY GROVE ADVENTIST HOSPITAL",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "20878",
            "telephone_number": "240-826-7550",
            "fax_number": "240-364-9020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VETERE",
        "first_name": "NICOLE",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-22",
        "last_updated": "2016-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MD",
            "license": "D0064079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "EVANCICH",
            "middle_name": "S",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Veritas Concierge Primary Care
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• Emergency Medicine Physician in Rockville, MD
• Providers in Rockville, MD by specialty
• Emergency Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 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.