Active NPI
Niel Nielson Veirup IV, DO
- Student in an Organized Health Care Education/Training Program
- Washington, DC
National Provider Identifier
1952981011
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- DO210012556
- Practice address
- 111 Michigan Ave NW FL 1.5
Washington, DC 20010-2916 - Phone
- (202) 476-3395
- NPI assigned
- Apr 13, 2021
- Last updated
- Aug 2, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | H0104314 | MD | |
| Student in an Organized Health Care Education/Training Program | 390200000X | 0102209247 | VA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | DO210012556 | DC | Primary |
| General Practice Physician | 208D00000X | OS20269 | FL |
Addresses
Primary practice location
111 Michigan Ave NW FL 1.5
Washington, DC 20010-2916
Mailing address
11034 Hiawatha Blvd
Mokena, IL 60448-1629
Phone (708) 653-8613
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- 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 |
|---|---|---|---|---|
| I20230921002514 | FL | Practitioner - General Practice | 1254731821 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DO210012556 | DC | MD | Student in an Organized Health Care Education/Training Program |
| H0104314 | MD | MD | Student in an Organized Health Care Education/Training Program |
| 0102209247 | VA | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1754092800000",
"number": "1952981011",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11034 HIAWATHA BLVD",
"city": "MOKENA",
"state": "IL",
"postal_code": "604481629",
"telephone_number": "708-653-8613"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 MICHIGAN AVE NW FL 1.5",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200102916",
"telephone_number": "202-476-3395"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VEIRUP",
"first_name": "NIEL",
"middle_name": "NIELSON",
"name_suffix": "IV",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-04-13",
"last_updated": "2025-08-02",
"certification_date": "2025-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "MD",
"license": "H0104314",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "VA",
"license": "0102209247",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "DC",
"license": "DO210012556",
"primary": true
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "FL",
"license": "OS20269",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2025; 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.