Anne M. Nickodem, MD PC

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

0101047333 Issued in VA

Legal business name

ANNE M. NICKODEM, MD PC

Practice address

8229 Boone Blvd Ste 365
Vienna, VA 22182-2623

Phone

(703) 560-8711

Fax

(703) 560-8725

NPI assigned

Oct 17, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Anne M Nickodem, M.D.NPI 1487826491

Title

President

Phone

(703) 560-8711

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC, VA2 enrollments

Enrollment records 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Anne M Nickodem, M.D.

  • Plastic Surgery Physician
  • Vienna, VA
  • NPI 1487826491

  DC

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750032000000",
    "number": "1205916871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8229 BOONE BLVD STE 365",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822623",
            "telephone_number": "703-560-8711",
            "fax_number": "703-552-2015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8229 BOONE BLVD STE 365",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822623",
            "telephone_number": "703-560-8711",
            "fax_number": "703-560-8725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANNE M. NICKODEM, MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2025-06-16",
        "certification_date": "2025-06-16",
        "status": "A",
        "authorized_official_last_name": "NICKODEM",
        "authorized_official_first_name": "ANNE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-560-8711",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery",
            "state": "VA",
            "license": "0101047333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joanna Angeles, OD
• Kylie Nicole Angiel
• Josh Angulo, DC
• Maame Ama Afriyie Aninfeng, RBT
• Anne Arundel Dermatology, PA
• Annu Narayanan Pullarkat, PLLC
• Scheherazad Sherry Anoushfar, DDS
• Sonia Ansari, FNP
• Subine Anwar
• Apex Hand Therapy, LLC

• Plastic Surgery Physician in Vienna, VA
• Providers in Vienna, VA by specialty
• Plastic Surgery Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.