Active NPI
Pedro Otilio Nazario, M.D
- Family Medicine Physician
- Yorktown, VA
National Provider Identifier
1407835812
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 9769
- Practice address
- 1 U S Coast Guard TRN Ctr
Yorktown, VA 23690-5001 - Phone
- (757) 856-2306
- Fax
- (757) 856-2276
- NPI assigned
- Jan 13, 2006
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 9769 | PR | Primary |
Addresses
Primary practice location
1 U S Coast Guard TRN Ctr
Yorktown, VA 23690-5001
Mailing address
1 US Coast Guard Training Center
Yorktown, VA 23690
Phone (757) 856-2306
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9769 | PR | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137110400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1406678400000",
"number": "1407835812",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 US COAST GUARD TRAINING CENTER",
"city": "YORKTOWN",
"state": "VA",
"postal_code": "23690",
"telephone_number": "757-856-2306",
"fax_number": "757-856-2276"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 U S COAST GUARD TRN CTR",
"city": "YORKTOWN",
"state": "VA",
"postal_code": "236905001",
"telephone_number": "757-856-2306",
"fax_number": "757-856-2276"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NAZARIO",
"first_name": "PEDRO",
"middle_name": "OTILIO",
"name_prefix": "Dr.",
"credential": "M.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-13",
"last_updated": "2014-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "PR",
"license": "9769",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Yorktown, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.