Individual provider Active NPI

Yaw P. Baidoo, LMT

  • Massage Therapist
  • Woodbridge, VA
National Provider Identifier
1235617507
Registry record updated Jun 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
0019017773 Issued in VA
Practice address
14960 Potomac Heights PL Apt 503
Woodbridge, VA 22191
Phone
(703) 634-3424
NPI assigned
Jul 30, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2020

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X PN1 ZZ
Nutrition Education Nutritionist 133NN1002X PN1 ZZ
Health Educator 174H00000X 813532 IN
Clinical Exercise Physiologist 224Y00000X 813532 IN
Massage Therapist 225700000X 0019017773 VA Primary

Addresses

Primary practice location

14960 Potomac Heights PL Apt 503
Woodbridge, VA 22191

Mailing address

13842A Outlet Dr # 176
Silver Spring, MD 20904-4970
Phone (703) 634-3424

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
PN1ZZMDNutritionist
813532INMDHealth Educator
0019017773VAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Healthefit, LLC Nutritionist Current Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1532908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592352000000",
    "number": "1235617507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13842A OUTLET DR # 176",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209044970",
            "telephone_number": "703-634-3424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14960 POTOMAC HEIGHTS PL APT 503",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "22191",
            "telephone_number": "703-634-3424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAIDOO",
        "first_name": "YAW",
        "middle_name": "P.",
        "name_prefix": "Mr.",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-30",
        "last_updated": "2020-06-17",
        "certification_date": "2020-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "ZZ",
            "license": "PN1",
            "primary": false
        },
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": "ZZ",
            "license": "PN1",
            "primary": false
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": "IN",
            "license": "813532",
            "primary": false
        },
        {
            "code": "224Y00000X",
            "taxonomy_group": "",
            "desc": "Clinical Exercise Physiologist",
            "state": "IN",
            "license": "813532",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "VA",
            "license": "0019017773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2020; 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.