Active NPI
Samantha Costanzo, MSOTR/L
- Pediatric Occupational Therapist
- Springfield, VA
National Provider Identifier
1124485982
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- 0119006826
- Practice address
- 7001A Loisdale Rd
Springfield, VA 22150-1904 - Phone
- (703) 971-0602
- NPI assigned
- Jan 25, 2016
- 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 |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 0119006826 | VA | Primary |
Addresses
Primary practice location
7001A Loisdale Rd
Springfield, VA 22150-1904
Mailing address
7001A Loisdale Rd
Springfield, VA 22150-1904
Phone (703) 971-0602
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 |
|---|---|---|---|
| 0119006826 | VA | MD | Pediatric Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Exceptional Childrens Center, LLC | Pediatrics | 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 and National Provider Directory roles.
-
- Pediatric Occupational Therapist
- Alexandria, VA
- NPI 1558560631
Pediatrics
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1453680000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1453680000000",
"number": "1124485982",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7001A LOISDALE RD",
"city": "SPRINGFIELD",
"state": "VA",
"postal_code": "221501904",
"telephone_number": "703-971-0602"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7001A LOISDALE RD",
"city": "SPRINGFIELD",
"state": "VA",
"postal_code": "221501904",
"telephone_number": "703-971-0602"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COSTANZO",
"first_name": "SAMANTHA",
"credential": "MSOTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-01-25",
"last_updated": "2016-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "VA",
"license": "0119006826",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springfield, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.