Olivia Tyra

Primary specialty

Physical Rehabilitation Occupational TherapistTaxonomy code 225XP0019X

License

1201139845 Issued in TN

Practice address

8607 Westwood Center Dr Ste 7
Vienna, VA 22182-7506

Phone

(703) 313-1930

NPI assigned

Apr 29, 2021

Last updated

Apr 29, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• OT Wigs & Extensions Design LLC

  • Durable Medical Equipment & Medical Supplies
  • Vienna, VA
  • NPI 1376124511
  NPD Authorized official

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

{
    "created_epoch": "1619654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619654400000",
    "number": "1295318186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8607 WESTWOOD CENTER DR STE 7",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221827506",
            "telephone_number": "703-313-1930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8607 WESTWOOD CENTER DR STE 7",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221827506",
            "telephone_number": "703-313-1930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYRA",
        "first_name": "OLIVIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-29",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "TN",
            "license": "1201139845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "ot.hairdesign@gmail.com",
            "affiliation": "N",
            "address_1": "8607 Westwood Center Dr Ste 7",
            "city": "Vienna",
            "state": "VA",
            "country_code": "US",
            "postal_code": "221827506",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Demet D Tunc, O.D.
• Turning Leaf Counseling Services LLC
• Sallie Twentyman, MSW, LCSW
• Jacqueline Leigh Tyler, LCSW
• Tazhae Tyler
• Tyson Orthodontics, PC
• Tyson Urgent Care, LLC
• David Sheldon Tyson, LCSW, LCSW-C, LICSW
• Tyson's Pain Center, P.C.
• Tysons Corner Advanced Dental Center PC

• Physical Rehabilitation Occupational Therapist in Vienna, VA
• Providers in Vienna, VA by specialty
• Physical Rehabilitation Occupational Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 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.

Verify at the official NPI Registry.