Organization Active NPI

Brain Executive, LLC

  • Pediatric Occupational Therapist
  • Alexandria, VA
National Provider Identifier
1336930965
Registry record updated Aug 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
Legal business name
BRAIN EXECUTIVE, LLC
Practice address
2007 Old Stage Rd
Alexandria, VA 22308-2237
Phone
(757) 633-8940
NPI assigned
May 14, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2026

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

Authorized official

Name
Kathryn Ann Hamlin-Pacheco, OTR/LNPI 1144729625
Title
Owner
Phone
(757) 633-8940

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225XP0200X Primary

Addresses

Primary practice location

2007 Old Stage Rd
Alexandria, VA 22308-2237

Mailing address

16366 N Shore Dr
Pensacola, FL 32507-8372
Phone (757) 633-8940

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1747180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786406400000",
    "number": "1336930965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16366 N SHORE DR",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325078372",
            "telephone_number": "757-633-8940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2007 OLD STAGE RD",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223082237",
            "telephone_number": "757-633-8940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAIN EXECUTIVE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-14",
        "last_updated": "2026-08-11",
        "certification_date": "2026-08-11",
        "status": "A",
        "authorized_official_last_name": "HAMLIN-PACHECO",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "757-633-8940",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2026; 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.