Individual provider Active NPI

Solomon Bak

  • Occupational Therapist
  • Woodbridge, VA
National Provider Identifier
1427629823
Registry record updated Jul 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
3940 Prince William Pkwy
Woodbridge, VA 22192-4513
Phone
(703) 680-0600
NPI assigned
Jul 7, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X Primary

Addresses

Primary practice location

3940 Prince William Pkwy
Woodbridge, VA 22192-4513

Mailing address

742 Brookside Dr
Newport News, VA 23602-8855
Phone (757) 897-0250

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

NPI Registry JSON

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

{
    "created_epoch": "1625616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625616000000",
    "number": "1427629823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "742 BROOKSIDE DR",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236028855",
            "telephone_number": "757-897-0250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3940 PRINCE WILLIAM PKWY",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221924513",
            "telephone_number": "703-680-0600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAK",
        "first_name": "SOLOMON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-07-07",
        "last_updated": "2021-07-07",
        "certification_date": "2021-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 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.