Individual provider Active NPI

Eklyn Robert

  • Licensed Practical Nurse
  • Fairfax, VA
National Provider Identifier
1942809405
Registry record updated Oct 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
0002093650 Issued in VA
Practice address
4000 Legato Rd Ste 1100
Fairfax, VA 22033-2893
Phone
(570) 534-8222
NPI assigned
Oct 25, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 0002093650 VA Primary

Addresses

Primary practice location

4000 Legato Rd Ste 1100
Fairfax, VA 22033-2893

Mailing address

4000 Legato Rd Ste 1100
Fairfax, VA 22033-2893
Phone (570) 534-8222

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

State licenses

LicenseStateTypeSpecialty
0002093650VAMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Opdynasty LLC Current Accepting new patients

Locations

4000 Legato Rd
Ste 1100
Fairfax, VA 22033
Phone (703) 672-3960

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1603584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603584000000",
    "number": "1942809405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 LEGATO RD STE 1100",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220332893",
            "telephone_number": "570-534-8222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 LEGATO RD STE 1100",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220332893",
            "telephone_number": "570-534-8222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERT",
        "first_name": "EKLYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-25",
        "last_updated": "2020-10-25",
        "certification_date": "2020-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "VA",
            "license": "0002093650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2020; 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.