Individual provider Active NPI

Amy Carrera, OTD, OTR/L

  • Occupational Therapist
  • Fairfax, VA
National Provider Identifier
1447637566
Registry record updated Apr 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
0119009939 Issued in VA
Practice address
9207 Arlington Blvd
Fairfax, VA 22031-2501
Phone
(703) 691-0046
NPI assigned
Apr 27, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2024

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 0119009939 VA Primary

Addresses

Primary practice location

9207 Arlington Blvd
Fairfax, VA 22031-2501

Mailing address

1465 S Highview LN Apt 203
Alexandria, VA 22311-2338
Phone (469) 371-7537

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240418000204 VA Practitioner - Occupational Therapist in Private Practice 4385083765 Reassigns benefits to 1 organization
I20240524000597 DC Practitioner - Occupational Therapist in Private Practice 4385083765 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0119009939VAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Prestige Rehab LLC Occupational Therapist CurrentSince Mar 1, 2024 Accepting new patients
Prestige Rehab VA PLLC Occupational Therapist CurrentSince Oct 1, 2024 Accepting new patients

Locations

2807 N Parham Rd
Ste 320
Richmond, VA 23294
Phone (571) 275-5935

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1430092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713398400000",
    "number": "1447637566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1465 S HIGHVIEW LN APT 203",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223112338",
            "telephone_number": "469-371-7537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9207 ARLINGTON BLVD",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220312501",
            "telephone_number": "703-691-0046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRERA",
        "first_name": "AMY",
        "name_prefix": "Dr.",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-27",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "VA",
            "license": "0119009939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.