Berna Amistoso Viado, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT871011 Issued in DC

Practice address

3264 Kaiser Dr
Ellicott City, MD 21043-4555

Phone

(410) 750-9006

NPI assigned

Apr 26, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1240704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240704000000",
    "number": "1558505214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3264 KAISER DR",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210434555",
            "telephone_number": "410-750-9006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3264 KAISER DR",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210434555",
            "telephone_number": "410-750-9006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIADO",
        "first_name": "BERNA",
        "middle_name": "AMISTOSO",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-26",
        "last_updated": "2009-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "DC",
            "license": "PT871011",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501014363",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "030405",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DC PT LICENSE",
            "identifier": "PT871011",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW YORK PT LICENSE",
            "identifier": "030405",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MI PT LICENSE",
            "identifier": "5501014363",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Ellicott City, MD
• Providers in Ellicott City, MD by specialty
• Physical Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2009; 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.