Active NPI
Sophia Theodora Ann Gillam
- Occupational Therapist
- Gainesville, VA
National Provider Identifier
1033093406
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 0119011109
- Practice address
- 7051 Heathcote Village Way Ste 105
Gainesville, VA 20155-3197 - Phone
- (703) 291-1254
- NPI assigned
- Jul 31, 2025
- 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 Therapist | 225X00000X | 0119011109 | VA | Primary |
Addresses
Primary practice location
7051 Heathcote Village Way Ste 105
Gainesville, VA 20155-3197
Mailing address
7051 Heathcote Village Way Ste 105
Gainesville, VA 20155-3197
Phone (703) 291-1254
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 |
|---|---|---|---|
| 0119011109 | VA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1753920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1758758400000",
"number": "1033093406",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7051 HEATHCOTE VILLAGE WAY STE 105",
"city": "GAINESVILLE",
"state": "VA",
"postal_code": "201553197",
"telephone_number": "703-291-1254"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7051 HEATHCOTE VILLAGE WAY STE 105",
"city": "GAINESVILLE",
"state": "VA",
"postal_code": "201553197",
"telephone_number": "703-291-1254"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILLAM",
"first_name": "SOPHIA",
"middle_name": "THEODORA ANN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-07-31",
"last_updated": "2025-09-25",
"certification_date": "2025-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "VA",
"license": "0119011109",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gainesville, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.