Individual provider Active NPI

Carlita Tibbs, RBT

  • Behavior Technician
  • Herndon, VA
National Provider Identifier
1245811728
Registry record updated Apr 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
297 Herndon Pkwy Ste 301
Herndon, VA 20170-4469
Phone
(571) 241-8557
NPI assigned
Apr 16, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Primary

Addresses

Primary practice location

297 Herndon Pkwy Ste 301
Herndon, VA 20170-4469

Mailing address

297 Herndon Pkwy Ste 301
Herndon, VA 20170-4469
Phone (571) 241-8557

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20241126000627 VA Practitioner - Occupational Therapist in Private Practice 4385179415 Reassigns benefits to 1 organization
I20241129000363 DC Practitioner - Occupational Therapist in Private Practice 4385179415 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fox Rehabilitation Services LLCGroup PAC ID 1355347410, 304 clinicians

Practice addresses (Care Compare)

3925 Downs Dr
Chantilly, VA 20151-3308
Phone (703) 810-3992

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehabilitation Services LLC CurrentSince Oct 1, 2024 Accepting new patients

Locations

7 Carnegie Plz
Cherry Hill, NJ 08003

20 E Piccadilly St
Ste 1114
Winchester, VA 22601

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.

NPI Registry JSON

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

{
    "created_epoch": "1618531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618531200000",
    "number": "1245811728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "297 HERNDON PKWY STE 301",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201704469",
            "telephone_number": "571-241-8557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "297 HERNDON PKWY STE 301",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201704469",
            "telephone_number": "571-241-8557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIBBS",
        "first_name": "CARLITA",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-16",
        "last_updated": "2021-04-16",
        "certification_date": "2021-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Herndon, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2021; 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.