Active NPI
Andre C. L. Liem, M.D.
- Physical Medicine & Rehabilitation Physician
- Fort Belvoir, VA
National Provider Identifier
1942648787
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- License
- 28143
- Practice address
- Atammc
9300 Dewitt Loop
Fort Belvoir, VA 22060 - Phone
- (202) 868-3847
- NPI assigned
- Jun 13, 2013
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | 28143 | NE | Primary |
Addresses
Primary practice location
Atammc
9300 Dewitt Loop
Fort Belvoir, VA 22060
Mailing address
Bamc
3551 Roger Brooke Drive
Fort Sam Houston, TX 78234-4504
Phone (202) 868-3847
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NE
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240626000767 | NE | Order and Referring Only - Physical Medicine and Rehabilitation | 7315481850 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28143 | NE | MD | Physical Medicine & Rehabilitation Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1371081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719446400000",
"number": "1942648787",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "BAMC",
"address_2": "3551 ROGER BROOKE DRIVE",
"city": "FORT SAM HOUSTON",
"state": "TX",
"postal_code": "782344504",
"telephone_number": "202-868-3847"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "ATAMMC",
"address_2": "9300 DEWITT LOOP",
"city": "FORT BELVOIR",
"state": "VA",
"postal_code": "22060",
"telephone_number": "202-868-3847"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIEM",
"first_name": "ANDRE",
"middle_name": "C. L.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-06-13",
"last_updated": "2024-06-27",
"certification_date": "2024-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "NE",
"license": "28143",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Belvoir, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.