Active NPI
Vivian Ezieke
- Physical Therapist
- Silver Spring, MD
National Provider Identifier
1992099253
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 25464
- Practice address
- 8505 Springvale Rd
Silver Spring, MD 20910-4344 - Phone
- (301) 830-6560
- Fax
- (301) 830-6560
- NPI assigned
- Jun 4, 2011
- Sex
- Female
- Sole proprietor
- No
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 Therapist | 225100000X | 25464 | MD | Primary |
Addresses
Primary practice location
8505 Springvale Rd
Silver Spring, MD 20910-4344
Mailing address
8505 Springvale Rd
Silver Spring, MD 20910-4344
Phone (301) 830-6560
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 25464 | Other | MD | MARYLAND PHYSICAL BOARD OF PHYSICAL THERAPY |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 25464 | MD | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1307145600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1466380800000",
"number": "1992099253",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8505 SPRINGVALE RD",
"city": "SILVER SPRING",
"state": "MD",
"postal_code": "209104344",
"telephone_number": "301-830-6560",
"fax_number": "301-830-6560"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8505 SPRINGVALE RD",
"city": "SILVER SPRING",
"state": "MD",
"postal_code": "209104344",
"telephone_number": "301-830-6560",
"fax_number": "301-830-6560"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EZIEKE",
"first_name": "VIVIAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-06-04",
"last_updated": "2016-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MD",
"license": "25464",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MARYLAND PHYSICAL BOARD OF PHYSICAL THERAPY",
"identifier": "25464",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Silver Spring, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.