NPIMap

Organization Active NPI

Axiom Link, Inc.

  • Rehabilitation Clinic/Center
  • Fairfax, VA
National Provider Identifier
1174852867
Registry record updated Apr 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
AXIOM LINK, INC.
Practice address
11240 Waples Mill Rd
Suite 101
Fairfax, VA 22030-6078
Phone
(703) 237-2219
Fax
(703) 237-2729
NPI assigned
Dec 9, 2009
Organization subpart
Yes
Parent organization
ACHIEVE BEYONDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 17, 2017

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

Authorized official

Name
Julia Sue MatuzaNPI 1548637333
Title
Ceo
Phone
(718) 762-7633

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X
Behavior TechnicianGroup: 193200000X MULTI-SPECIALTY GROUP 106S00000X
Pediatric Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251P0200X
Pediatric Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225XP0200X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X
Early Intervention Provider Agency 252Y00000X
Rehabilitation Clinic/Center 261QR0400X Primary

Addresses

Primary practice location

11240 Waples Mill Rd
Suite 101
Fairfax, VA 22030-6078

Mailing address

7000 Austin St
Suite 200
Forest Hills, NY 11375-1022
Phone (718) 762-7633

Other identifiers 1

IdentifierTypeStateIssuer
225720OtherMEDICARE PTAN

Other names 1

  • Achieve Beyond Doing business as

National Provider Directory

National Provider Directory
Part of
Achieve Beyond

Locations

11200 Waples Mill Rd
Fairfax, VA 22030

11200 Waples Mill Rd
Ste 100
Fairfax, VA 22030
Phone (571) 585-3999

11240 Waples Mill Rd
Ste 100
Fairfax, VA 22030

7143 Shreve Rd
Falls Church, VA 22043
Phone (703) 237-2119

Practitioners & affiliated clinicians

Practitioners 188

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 188

NPI Registry JSON

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

{
    "created_epoch": "1260316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492387200000",
    "number": "1174852867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7000 AUSTIN ST",
            "address_2": "SUITE 200",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113751022",
            "telephone_number": "718-762-7633",
            "fax_number": "718-886-8694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11240 WAPLES MILL RD",
            "address_2": "SUITE 101",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220306078",
            "telephone_number": "703-237-2219",
            "fax_number": "703-237-2729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AXIOM LINK, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ACHIEVE BEYOND",
        "enumeration_date": "2009-12-09",
        "last_updated": "2017-04-17",
        "status": "A",
        "authorized_official_last_name": "MATUZA",
        "authorized_official_first_name": "JULIA",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "718-762-7633"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "225720",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Achieve Beyond",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fairfax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.