Active NPI
Marena Gibbs
- Occupational Therapy Assistant
- Fairfax, VA
National Provider Identifier
1023766136
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- Practice address
- 11200 Waples Mill Rd Ste 100
Fairfax, VA 22030-7475 - Phone
- (703) 237-2219
- NPI assigned
- Mar 17, 2022
- Last updated
- Mar 17, 2022
- 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 |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | Primary |
Addresses
Primary practice location
11200 Waples Mill Rd Ste 100
Fairfax, VA 22030-7475
Mailing address
7915 Jones Branch Dr Apt 124
MC Lean, VA 22102-3228
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Axiom Link, Inc. | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1647475200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647475200000",
"number": "1023766136",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7915 JONES BRANCH DR APT 124",
"city": "MC LEAN",
"state": "VA",
"postal_code": "221023228"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11200 WAPLES MILL RD STE 100",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220307475",
"telephone_number": "703-237-2219"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBBS",
"first_name": "MARENA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-03-17",
"last_updated": "2022-03-17",
"certification_date": "2022-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": null,
"license": null,
"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 Mar 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.