Individual provider Active NPI

Kristi Lauren Collman, OTR/L

  • Occupational Therapist
  • Reston, VA
National Provider Identifier
1467726265
Registry record updated Nov 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
0119006984 Issued in VA
Practice address
12052 N Shore Dr
Reston, VA 20190-4969
Phone
(703) 834-9800
NPI assigned
Feb 27, 2012
Last updated
Nov 19, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 0119006984 VA Primary
Occupational Therapist 225X00000X 06813 MD

Addresses

Primary practice location

12052 N Shore Dr
Reston, VA 20190-4969

Mailing address

8300 Wyoming Blvd NE
Albuquerque, NM 87113-1997
Phone (240) 818-1995

Other practice location 1

21627 o'toole dr
Hagerstown, MD 21742-9738
Phone (240) 818-1995

Other identifiers 1

IdentifierTypeStateIssuer
1467726265OtherVAMED B

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
0119006984VAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1330300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637280000000",
    "number": "1467726265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8300 WYOMING BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871131997",
            "telephone_number": "240-818-1995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12052 N SHORE DR",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201904969",
            "telephone_number": "703-834-9800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21627 o'toole dr",
            "address_purpose": "LOCATION",
            "city": "Hagerstown",
            "state": "MD",
            "postal_code": "217429738",
            "country_code": "US",
            "telephone_number": "240-818-1995",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLLMAN",
        "first_name": "KRISTI",
        "middle_name": "LAUREN",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-27",
        "last_updated": "2021-11-19",
        "certification_date": "2021-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "VA",
            "license": "0119006984",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MD",
            "license": "06813",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MED B",
            "identifier": "1467726265",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reston, VA

Sources for this page

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