Andrea Renee Detar

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

0119002336 Issued in VA

Practice address

10014 Windridge Dr
Fredericksburg, VA 22407-4364

Phone

(540) 898-1118

NPI assigned

May 29, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Andrea Renee Detar Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013118066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10014 WINDRIDGE DR",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224074364",
            "telephone_number": "540-898-1118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10014 WINDRIDGE DR",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224074364",
            "telephone_number": "540-898-1118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETAR",
        "first_name": "ANDREA",
        "middle_name": "RENEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "VA",
            "license": "0119002336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "DETAR",
            "middle_name": "RENEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kevin Ray Deshazo, PHARMACY TECHNICIAN
• Amanda Britt Deshler, PT
• Paul Armand Desilets
• Desired Transport Services, LLC
• Desiring Health LLC
• Frank J Detrane, M.D.
• Randi Lee Dettling, PA-C
• Michael Deutsch, PA
• Eric Alphaeus Devairakkam, DO
• Matthew C Devries, PTA

• Occupational Therapist in Fredericksburg, VA
• Providers in Fredericksburg, VA by specialty
• Occupational Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.