Barry B. Ekdom, PH.D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

0810001775 Issued in VA

Practice address

3040 Williams Dr
Suite 402
Fairfax, VA 22031-4618

Phone

(703) 573-3573

Fax

(703) 573-3574

NPI assigned

Nov 15, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Barry B Ekdom PHD, PCGroup PAC ID 6901101807, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Barry B Ekdom PHD, PC

  • Clinical Neuropsychologist
  • Fairfax, VA
  • NPI 1194804914

  DC

  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1195084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717372800000",
    "number": "1457532756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3040 WILLIAMS DR",
            "address_2": "SUITE 402",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314618",
            "telephone_number": "703-573-3573",
            "fax_number": "703-573-3574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3040 WILLIAMS DR",
            "address_2": "SUITE 402",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314618",
            "telephone_number": "703-573-3573",
            "fax_number": "703-573-3574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EKDOM",
        "first_name": "BARRY",
        "middle_name": "B.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-15",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "VA",
            "license": "0810001775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nawal M Eid, CCC-SLP
• Philip David Eiseman
• Marc Eisenbaum, M.D.
• Rachel Fannell Eisenfeld, C-PED, O.F
• Nastaran Ejtemai, DDS
• Gladys Ekoto
• Rani El-Hinnawi, RPH
• Heather Andice El-Zein, M.A.
• Tamara L Elassal, LPC, NCC
• Doaa Elberry

• Clinical Neuropsychologist in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Clinical Neuropsychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.