Active NPI
Revathi Vikram
- Psychiatry Physician
- Derwood, MD
National Provider Identifier
1285090530
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- D0023359
- Practice address
- 17050 Catalpa CT
Derwood, MD 20855-2576 - Phone
- (240) 912-7185
- NPI assigned
- Dec 31, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | D0023359 | MD | Primary |
Addresses
Primary practice location
17050 Catalpa CT
Derwood, MD 20855-2576
Mailing address
17050 Catalpa CT
Derwood, MD 20855-2576
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 |
|---|---|---|---|
| D0023359 | MD | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1451520000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1451520000000",
"number": "1285090530",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17050 CATALPA CT",
"city": "DERWOOD",
"state": "MD",
"postal_code": "208552576"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17050 CATALPA CT",
"city": "DERWOOD",
"state": "MD",
"postal_code": "208552576",
"telephone_number": "240-912-7185"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VIKRAM",
"first_name": "REVATHI",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-12-31",
"last_updated": "2015-12-31",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MD",
"license": "D0023359",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Derwood, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.