Active NPI
Robert Edward Macdonnell, OCCUPATIONAL THERAPI
- Military Health Care Provider
- Dumfries, VA
National Provider Identifier
1063710515
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Military Health Care Provider
- License
- 0119002314
- Practice address
- 700 Fettler Park
Dumfries Health Center
Dumfries, VA 22025 - Phone
- (703) 441-7500
- NPI assigned
- Mar 8, 2011
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Military Health Care Provider | 171000000X | 0119002314 | VA | Primary |
Addresses
Primary practice location
700 Fettler Park
Dumfries Health Center
Dumfries, VA 22025
Mailing address
3700 Fettler Park
Dumfries Health Center
Dumfries, VA 22025
Phone (703) 441-7500
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 |
|---|---|---|---|
| 0119002314 | VA | MD | Military Health Care Provider |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1299542400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1367280000000",
"number": "1063710515",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3700 FETTLER PARK",
"address_2": "DUMFRIES HEALTH CENTER",
"city": "DUMFRIES",
"state": "VA",
"postal_code": "22025",
"telephone_number": "703-441-7500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 FETTLER PARK",
"address_2": "DUMFRIES HEALTH CENTER",
"city": "DUMFRIES",
"state": "VA",
"postal_code": "22025",
"telephone_number": "703-441-7500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACDONNELL",
"first_name": "ROBERT",
"middle_name": "EDWARD",
"name_prefix": "Mr.",
"credential": "OCCUPATIONAL THERAPI",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-03-08",
"last_updated": "2013-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "171000000X",
"taxonomy_group": "",
"desc": "Military Health Care Provider",
"state": "VA",
"license": "0119002314",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dumfries, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.