Individual provider Active NPI

Vivian A Nzedu, MD

  • Pediatrics Physician
  • Manassas, VA
National Provider Identifier
1659349975
Registry record updated Sep 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
0101242598 Issued in VA
Practice address
9430 Forestwood LN Ste 100
Manassas, VA 20110-4754
Phone
(703) 365-0227
Fax
(703) 365-0332
NPI assigned
Mar 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 0101242598 VA Primary
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X 23739 OK
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X 0101242598 VA

Addresses

Primary practice location

9430 Forestwood LN Ste 100
Manassas, VA 20110-4754

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other practice location 1

940 NE 13th St
1B1206
Oklahoma City, OK 73104-5008
Phone (405) 271-4881

Other practice location 2

1850 Town Center Pkwy
Reston, VA 20190-3204
Phone (240) 686-2300

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address vnzedu306753@direct.novanthealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20091013000235 DC Practitioner - Pediatric Medicine 8224010988 Reassigns benefits to 2 organizations
I20091016000562 VA Practitioner - Pediatric Medicine 8224010988 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101242598VAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Uva Community Health Medical Group, LLC Pediatrics CurrentSince Aug 1, 2021 Accepting new patients
Uva Community Health Medical Group, LLC CurrentSince Aug 1, 2021 Accepting new patients
Emergency Medicine Associates P.a., P.C. CurrentSince Aug 30, 2009 Accepting new patients
Emergency Medicine Associates, P.a.,P.C. CurrentSince Aug 30, 2009 Accepting new patients
Emergency Medicine Associates P.a., P.C. Pediatrics CurrentSince Jul 20, 2021 Accepting new patients
Trustees of Columbia University in the City of New York Pediatrics Past Accepting new patients
Uva Community Health Medical Group, LLC Past Accepting new patients

Locations

20010 Century Blvd
Ste 200
Germantown, MD 20874

200 Memorial Ave
Westminster, MD 21157
Phone (410) 848-3000

4320 Seminary Rd
Alexandria, VA 22304
Phone (703) 504-3000

1701 N George Mason Dr
Arlington, VA 22205
Phone (703) 558-5000

4105 Lewis and Clark Dr
Charlottesvle, VA 22911

100 Fairview Dr
Franklin, VA 23851
Phone (757) 516-1153

8180 Stonewall Shops Sq
Gainesville, VA 20155
Phone (703) 365-0227

15225 Heathcote Blvd
Haymarket, VA 20169
Phone (571) 284-1000

9430 Forestwood Ln
Ste 100
Manassas, VA 20110
Phone (571) 284-1430

8700 Sudley Rd
Manassas, VA 20110
Phone (703) 369-8000

1850 Town Center Pkwy
Reston, VA 20190
Phone (703) 478-0922

Organizations & group practices 8

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

NPI Registry JSON

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

{
    "created_epoch": "1142035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631232000000",
    "number": "1659349975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9430 FORESTWOOD LN STE 100",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201104754",
            "telephone_number": "703-365-0227",
            "fax_number": "703-365-0332"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "940 NE 13th St",
            "address_2": "1B1206",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731045008",
            "country_code": "US",
            "telephone_number": "405-271-4881",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1850 Town Center Pkwy",
            "address_purpose": "LOCATION",
            "city": "Reston",
            "state": "VA",
            "postal_code": "201903204",
            "country_code": "US",
            "telephone_number": "240-686-2300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NZEDU",
        "first_name": "VIVIAN",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-11",
        "last_updated": "2021-09-10",
        "certification_date": "2021-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101242598",
            "primary": true
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "OK",
            "license": "23739",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "VA",
            "license": "0101242598",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vnzedu306753@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "9430 Forestwood Ln Ste 100",
            "city": "Manassas",
            "state": "VA",
            "country_code": "US",
            "postal_code": "201104754",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Manassas, VA

Sources for this page

Verify at the official NPI Registry.