Active NPI
Yaw P. Baidoo, LMT
- Massage Therapist
- Woodbridge, VA
National Provider Identifier
1235617507
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 0019017773
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| PN1 | ZZ | MD | Nutritionist |
| 813532 | IN | MD | Health Educator |
| 0019017773 | VA | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Durable Medical Equipment & Medical Supplies
- New Orleans, LA
- NPI 1801308903
Nutritionist
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.