Active NPI
John Philip Neisser, MD
- General Practice Physician
- Fredericksburg, VA
National Provider Identifier
1376723015
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128b(4) exclusion effective Apr 18, 2013.
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 0101245966
- Practice address
- 6902 Governors Grant LN
Fredericksburg, VA 22407-8573 - Phone
- (504) 453-4401
- NPI assigned
- Nov 10, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 0101245966 | VA | Primary |
Addresses
Primary practice location
6902 Governors Grant LN
Fredericksburg, VA 22407-8573
Mailing address
6902 Governors Grant LN
Fredericksburg, VA 22407-8573
Phone (504) 453-4401
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101245966 | VA | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1194652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1358380800000",
"number": "1376723015",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6902 GOVERNORS GRANT LN",
"city": "FREDERICKSBURG",
"state": "VA",
"postal_code": "224078573",
"telephone_number": "504-453-4401"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6902 GOVERNORS GRANT LN",
"city": "FREDERICKSBURG",
"state": "VA",
"postal_code": "224078573",
"telephone_number": "504-453-4401"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEISSER",
"first_name": "JOHN",
"middle_name": "PHILIP",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-11-10",
"last_updated": "2013-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "VA",
"license": "0101245966",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fredericksburg, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.