Active NPI
Keriya Adem, MD
- Pediatrics Physician
- Leesburg, VA
National Provider Identifier
1750418455
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 0101243453
- Practice address
- 19450 Deerfield Ave
Suite 200
Leesburg, VA 20176-6820 - Phone
- (702) 724-7337
- Fax
- (703) 724-6848
- NPI assigned
- Feb 28, 2007
- Last updated
- Feb 19, 2010
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 0101243453 | VA | Primary |
Addresses
Primary practice location
19450 Deerfield Ave
Suite 200
Leesburg, VA 20176-6820
Mailing address
PO Box 17334
Baltimore, MD 21297-1334
Phone (703) 443-6717
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750418455 | Medicaid | VA |
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 |
|---|---|---|---|
| 0101243453 | VA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Loudoun Medical Group, PC | Pediatrics | Past | Accepting new patients |
Interoperability endpoints
- keriya.adem@lmg1.eclinicaldirectplus.com
Organizations & group practices 1
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": "1172620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1266537600000",
"number": "1750418455",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 17334",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212971334",
"telephone_number": "703-443-6717",
"fax_number": "703-443-8643"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19450 DEERFIELD AVE",
"address_2": "SUITE 200",
"city": "LEESBURG",
"state": "VA",
"postal_code": "201766820",
"telephone_number": "702-724-7337",
"fax_number": "703-724-6848"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ADEM",
"first_name": "KERIYA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-28",
"last_updated": "2010-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "VA",
"license": "0101243453",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1750418455",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.