Gary Don Cobb, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0814001673 Issued in VA

Practice address

4001 Fair Ridge Dr
Suite 305
Fairfax, VA 22033-2917

Phone

(703) 883-4774

Fax

(703) 218-1824

NPI assigned

Jan 3, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Apr 1, 2021 through Apr 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Michael R. Hryvniak, M.D., P.C.

  • Psychiatry Physician
  • Fairfax, VA
  • NPI 1699910679
  NPD (past)

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245397751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4001 FAIR RIDGE DR",
            "address_2": "SUITE 305",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220332917",
            "telephone_number": "703-883-4774",
            "fax_number": "703-218-1824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 FAIR RIDGE DR",
            "address_2": "SUITE 305",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220332917",
            "telephone_number": "703-883-4774",
            "fax_number": "703-218-1824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COBB",
        "first_name": "GARY",
        "middle_name": "DON",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0814001673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Armistead Clinton, NP
• Kimberly Sue Close-Jensen, LCSW
• Cloud Therapy Consulting Inc
• Joanna M Clough, DO
• CNMC
• Paul Irvin Coble, LPC
• Jessica Marie Cochran, PA
• Kara S Cochran, PA
• Costanza Cocilovo, MD
• Julia Virginia Cockrill, LMFT

• Clinical Psychologist in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Clinical Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.