Active NPI
Ashley Nicole Destefano, MOT OTR
- Occupational Therapist
- Annandale, VA
National Provider Identifier
1184219677
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- Practice address
- 7112 Braddock Rd
Annandale, VA 22003-6007 - Phone
- (703) 256-2525
- NPI assigned
- Mar 5, 2021
- 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 | Primary |
Addresses
Primary practice location
7112 Braddock Rd
Annandale, VA 22003-6007
Mailing address
137 Jasper PL
Alexandria, VA 22304-4905
Phone (740) 632-8774
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1614902400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1634169600000",
"number": "1184219677",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "137 JASPER PL",
"city": "ALEXANDRIA",
"state": "VA",
"postal_code": "223044905",
"telephone_number": "740-632-8774"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7112 BRADDOCK RD",
"city": "ANNANDALE",
"state": "VA",
"postal_code": "220036007",
"telephone_number": "703-256-2525"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DESTEFANO",
"first_name": "ASHLEY",
"middle_name": "NICOLE",
"credential": "MOT OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-03-05",
"last_updated": "2021-10-14",
"certification_date": "2021-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Annandale, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.