Individual provider Active NPI

Ebenezer Gyimah Sarpong

  • Skilled Nursing Facility
  • Alexandria, VA
National Provider Identifier
1811363682
Registry record updated Aug 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Practice address
8111 Tis Well Dr
Alexandria, VA 22306-3211
Phone
(703) 360-4000
NPI assigned
Aug 17, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 17, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

8111 Tis Well Dr
Alexandria, VA 22306-3211

Mailing address

2511 Windbreak Dr
Alexandria, VA 22306-2605
Phone (571) 420-7032

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

NPI Registry JSON

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

{
    "created_epoch": "1439769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439769600000",
    "number": "1811363682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2511 WINDBREAK DR",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223062605",
            "telephone_number": "571-420-7032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8111 TIS WELL DR",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223063211",
            "telephone_number": "703-360-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GYIMAH SARPONG",
        "first_name": "EBENEZER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-08-17",
        "last_updated": "2015-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2015; 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.