ICON MEDICINE NPI 1477269447

NPI Information

  • NPI: 1477269447
  • Provider Name: ICON MEDICINE
  • Classification: Clinic/Center - 261QM1300X
  • Specialization: Multi-Specialty
  • Entity Type: Organization
  • :
  • Address: 7411 RIGGS RD STE 300B
    HYATTSVILLE, MD
    ZIP 20783
  • Phone: (240) 966-4266

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NPI Details

ICON MEDICINE is a multi-specialty clinic center in Hyattsville, MD. ICON MEDICINE NPI is 1477269447. The provider is registered as an organization entity type and is a single specialty group.
The provider .

The provider's business location address is:

7411 RIGGS RD STE 300B
HYATTSVILLE, MD
ZIP 20783-246
Phone: (240) 966-4266
Fax: (301) 235-1771

The provider's authorized official is Timothy Nyakango Onserio .
The authorized official title is Clinical Director and has the following contact phone number (240) 966-4266.

The enumeration date for this NPI number is 1/24/2023 and was last updated on 2/24/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineNo
2261QM1300XClinic/CenterMulti-SpecialtyYes
3261QP2300XClinic/CenterPrimary CareNo
4261QU0200XClinic/CenterUrgent CareNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1R189170OTHERMARYLANDCRNP LICENSE
2APRN11022989OTHERFLORIDAAPRN LICENSE
30024189089OTHERVIRGINIAAPRN LICENSE
4O-526793646572OTHERMARYLANDDRIVERS LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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