Active NPI
Brenda L Dennie, OTL
- Occupational Therapist
- Manassas, VA
National Provider Identifier
1508913005
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 0119000997
- Practice address
- 7969 Ashton Ave
Manassas, VA 20109-2885 - Phone
- (703) 792-7800
- Fax
- (703) 792-5699
- NPI assigned
- Jan 5, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 0119000997 | VA | Primary |
Addresses
Primary practice location
7969 Ashton Ave
Manassas, VA 20109-2885
Mailing address
7969 Ashton Ave
Manassas, VA 20109-2885
Phone (703) 792-7800
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 229732 | Other | VA | AMERIGROUP |
| 187840 | Other | VA | BLUE CROSS BLUE SHIELD |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0119000997 | VA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167955200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1508913005",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7969 ASHTON AVE",
"city": "MANASSAS",
"state": "VA",
"postal_code": "201092885",
"telephone_number": "703-792-7800",
"fax_number": "703-792-5699"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7969 ASHTON AVE",
"city": "MANASSAS",
"state": "VA",
"postal_code": "201092885",
"telephone_number": "703-792-7800",
"fax_number": "703-792-5699"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DENNIE",
"first_name": "BRENDA",
"middle_name": "L",
"name_prefix": "Ms.",
"credential": "OTL",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "VA",
"license": "0119000997",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIGROUP",
"identifier": "229732",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "187840",
"state": "VA"
}
],
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.