Individual provider Active NPI

Kimberly Mysinger, COTA

  • Occupational Therapy Assistant
  • Manassas, VA
National Provider Identifier
1346595345
Registry record updated Sep 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
0131001054 Issued in VA
Practice address
8575 Rixlew LN
Manassas, VA 20109-3701
Phone
(703) 257-9770
NPI assigned
Jul 17, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 0131001054 VA Primary

Addresses

Primary practice location

8575 Rixlew LN
Manassas, VA 20109-3701

Mailing address

6131 Sandstone CT
Clifton, VA 20124-2324
Phone (703) 815-8399

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0131001054VAMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1342483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348012800000",
    "number": "1346595345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6131 SANDSTONE CT",
            "city": "CLIFTON",
            "state": "VA",
            "postal_code": "201242324",
            "telephone_number": "703-815-8399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8575 RIXLEW LN",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201093701",
            "telephone_number": "703-257-9770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYSINGER",
        "first_name": "KIMBERLY",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-17",
        "last_updated": "2012-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "VA",
            "license": "0131001054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manassas, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2012; 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.