Individual provider Active NPI

Elizabeth Vienneau, MD

  • Obstetrics & Gynecology Physician
  • Annapolis, MD
National Provider Identifier
1831519693
Registry record updated Jun 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
D0085848 Issued in MD
Practice address
2003 Medical Pkwy Ste 250
Annapolis, MD 21401-3098
Phone
(410) 224-2228
Fax
(410) 266-7778
NPI assigned
Apr 21, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Obstetrics & Gynecology Physician 207V00000X D0085848 MD Primary

Addresses

Primary practice location

2003 Medical Pkwy Ste 250
Annapolis, MD 21401-3098

Mailing address

2003 Medical Pkwy Ste 250
Annapolis, MD 21401-3098
Phone (410) 224-2124

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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 1

Enrollment IDStateProvider typePAC IDDetails
I20180813002100 MD Practitioner - Obstetrics/Gynecology 9436466588 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Perelman School of Med at the University of Pennsylvania, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Privia Medical Group, LLCGroup PAC ID 4385682061, 1,522 clinicians

Practice addresses (Care Compare)

133 Defense Hwy
Annapolis, MD 21401-7015

2000 Medical Pkwy
Annapolis, MD 21401-3742
Phone (410) 571-9700

Hospital & facility affiliations

  • Luminis Health Anne Arundel Medical Center, Inc Hospital, Annapolis, MD, CCN 210023

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0085848MDMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC CurrentSince Jul 30, 2018 Accepting new patients
Privia Medical Group, LLC Obstetrics & Gynecology CurrentSince Jul 30, 2018 Accepting new patients
Nova Physician Wellness Center PLLC Past Accepting new patients

Locations

2003 Medical Pkwy
Ste 250
Annapolis, MD 21401
Phone (410) 224-2228

133 Defense Hwy
Ste 112
Annapolis, MD 21401
Phone (410) 573-0140

11350 Pembrooke Sq
Ste 304
Waldorf, MD 20603
Phone (301) 856-2810

950 N Glebe Rd
Ste 4000
Arlington, VA 22203
Phone (301) 593-9011

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
  • Direct secure messaging: elizabeth.vienneau.1@8042.direct.athenahealth.com

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1398038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624838400000",
    "number": "1831519693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2003 MEDICAL PKWY STE 250",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013098",
            "telephone_number": "410-224-2124",
            "fax_number": "410-266-7778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2003 MEDICAL PKWY STE 250",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013098",
            "telephone_number": "410-224-2228",
            "fax_number": "410-266-7778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIENNEAU",
        "first_name": "ELIZABETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-21",
        "last_updated": "2021-06-28",
        "certification_date": "2021-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MD",
            "license": "D0085848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

Verify at the official NPI Registry.