Individual provider Active NPI

Deepa Laxmi Shrestha, OTR L

  • Occupational Therapist
  • Reston, VA
National Provider Identifier
1164620423
Registry record updated Jul 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
0119004017 Issued in VA
Practice address
12052 N Shore Dr
Reston, VA 20190-4969
Phone
(703) 707-0706
NPI assigned
Jul 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 0119004017 VA Primary

Addresses

Primary practice location

12052 N Shore Dr
Reston, VA 20190-4969

Mailing address

11647 N Shore Dr
21
Reston, VA 20190-4613
Phone (571) 265-3441

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200717001569 VA Practitioner - Occupational Therapist in Private Practice 4486078862 Reassigns benefits to 2 organizations
I20220308001104 DC Practitioner - Occupational Therapist in Private Practice 4486078862 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Healthcare Services IncGroup PAC ID 2163339722, 3,431 clinicians

Practice addresses (Care Compare)

12751 Sudley Manor Dr
Bristow, VA 20136-2726
Phone (571) 379-8182

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0119004017VAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Healthcare Services Inc Occupational Therapist CurrentSince Mar 24, 2025 Accepting new patients
Comprehensive Therapeutics LTD Occupational Therapist CurrentSince Aug 20, 2021 Accepting new patients
Comprehensive Therapeutics LTD Occupational Therapist CurrentSince Aug 20, 2021 Accepting new patients
Legacy Healthcare Services Inc Occupational Therapist CurrentSince Mar 24, 2025 Accepting new patients

Locations

110 Horizon Dr
#310
Raleigh, NC 27615

12751 Sudley Manor Dr
Bristow, VA 20136
Phone (571) 379-8182

10286 Brook Rd
Glen Allen, VA 23059
Phone (571) 200-6617

3365 Ogden Rd
Roanoke, VA 24018
Phone (540) 682-7500

Organizations & group practices 4

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1184025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184025600000",
    "number": "1164620423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11647 N SHORE DR",
            "address_2": "21",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201904613",
            "telephone_number": "571-265-3441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12052 N SHORE DR",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201904969",
            "telephone_number": "703-707-0706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHRESTHA",
        "first_name": "DEEPA",
        "middle_name": "LAXMI",
        "credential": "OTR L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-10",
        "last_updated": "2007-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "VA",
            "license": "0119004017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reston, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.