Individual provider Active NPI

Emma P Vezikov, RN

  • Registered Nurse
  • Coventry, RI
National Provider Identifier
1336807106
Registry record updated Nov 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN51761 Issued in RI
Practice address
40 Ginger TRL
Coventry, RI 02816-8261
Phone
(401) 865-0003
NPI assigned
Nov 29, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN51761 RI Primary

Addresses

Primary practice location

40 Ginger TRL
Coventry, RI 02816-8261

Mailing address

40 Ginger TRL
Coventry, RI 02816-8261
Phone (401) 865-0003

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN51761RIMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1638144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1336807106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 GINGER TRL",
            "city": "COVENTRY",
            "state": "RI",
            "postal_code": "028168261",
            "telephone_number": "401-865-0003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 GINGER TRL",
            "city": "COVENTRY",
            "state": "RI",
            "postal_code": "028168261",
            "telephone_number": "401-865-0003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEZIKOV",
        "first_name": "EMMA",
        "middle_name": "P",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-29",
        "last_updated": "2021-11-29",
        "certification_date": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "RI",
            "license": "RN51761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coventry, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2021; 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.