Itoro Ibia, M.D.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

0101223034 Issued in VA

Practice address

11701 Bowman Green Dr
Reston, VA 20190-3573

Phone

(703) 707-9777

Fax

(703) 707-0690

NPI assigned

Oct 5, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Previously, effective Aug 25, 2018 through Aug 25, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)
• Psychotherapeutic Rehabilation Services

  • Psychiatry Physician
  • Landover, MD
  • NPI 1356484547
  NPD (past)

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

{
    "created_epoch": "1128470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1356338206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2963",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201950963",
            "telephone_number": "703-707-9777",
            "fax_number": "703-707-0690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11701 BOWMAN GREEN DR",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201903573",
            "telephone_number": "703-707-9777",
            "fax_number": "703-707-0690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBIA",
        "first_name": "ITORO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-05",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0101223034",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "VA",
            "license": "0101223034",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE FIRST BCBS ID",
            "identifier": "F480-0001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA ID",
            "identifier": "2037353",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS ID",
            "identifier": "466688",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER ID",
            "identifier": "7267195",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Renee Hyder
• Maria Antoinette Hylton, MSW, LCSW
• Janet Lynn Hyman, LCSW
• Joseph Arthur Hyman, PH.D.
• Christine Ibarguen, NP
• Ida Sue Baron, PH.D., P.C.
• Amazing-Grace Ighedo
• Hala Elham Imam, DDS
• Mfrie-Emem Ifiok Imoh, LPC
• Renee Indelicato, OT

• Child & Adolescent Psychiatry Physician in Reston, VA
• Providers in Reston, VA by specialty
• Child & Adolescent Psychiatry Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.