Active NPI
Andrea Pickles, OTR/L, RD
- Occupational Therapist
- MC Lean, VA
National Provider Identifier
1124379847
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 0119005203
- Practice address
- 8315 Turning Leaf LN
MC Lean, VA 22102-2615 - Phone
- (703) 288-0620
- NPI assigned
- Sep 20, 2012
- 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 | 0119005203 | VA | Primary |
Addresses
Primary practice location
8315 Turning Leaf LN
MC Lean, VA 22102-2615
Mailing address
633 Nathan PL NE
Leesburg, VA 20176-2351
Phone (607) 368-8113
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 |
|---|---|---|---|
| 0119005203 | VA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1348099200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1348099200000",
"number": "1124379847",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "633 NATHAN PL NE",
"city": "LEESBURG",
"state": "VA",
"postal_code": "201762351",
"telephone_number": "607-368-8113"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8315 TURNING LEAF LN",
"city": "MC LEAN",
"state": "VA",
"postal_code": "221022615",
"telephone_number": "703-288-0620"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PICKLES",
"first_name": "ANDREA",
"credential": "OTR/L, RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-09-20",
"last_updated": "2012-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "VA",
"license": "0119005203",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in MC Lean, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.