Active NPI
Nicole Marie Deyampert, MD
- Dermatology Physician
- Fort Myer, VA
National Provider Identifier
1285616979
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- D56332
- Practice address
- 401 Carpenter Rd
Fort Myer, VA 22211-1009 - Phone
- (703) 696-3630
- NPI assigned
- Nov 17, 2005
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | D56332 | MD | Primary |
Addresses
Primary practice location
401 Carpenter Rd
Fort Myer, VA 22211-1009
Mailing address
401 Carpenter Rd
Fort Myer, VA 22211-1009
Phone (703) 696-3630
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D56332 | MD | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132185600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1362700800000",
"number": "1285616979",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "401 CARPENTER RD",
"city": "FORT MYER",
"state": "VA",
"postal_code": "222111009",
"telephone_number": "703-696-3630"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 CARPENTER RD",
"city": "FORT MYER",
"state": "VA",
"postal_code": "222111009",
"telephone_number": "703-696-3630"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEYAMPERT",
"first_name": "NICOLE",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-17",
"last_updated": "2013-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "MD",
"license": "D56332",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Myer, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.