Individual provider Active NPI

Alycia Marie Johnson, OTD

  • Occupational Therapist
  • Virginia Beach, VA
National Provider Identifier
1588078687
Registry record updated Mar 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
0119006854 Issued in VA
Practice address
641 Carriage Hill Rd
Virginia Beach, VA 23452-6546
Phone
(757) 263-2800
NPI assigned
Jun 17, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 2014016768 MO
Occupational Therapist 225X00000X 17-02991 KS
Occupational Therapist 225X00000X 0119006854 VA Primary

Addresses

Primary practice location

641 Carriage Hill Rd
Virginia Beach, VA 23452-6546

Mailing address

641 Carriage Hill Rd
Virginia Beach, VA 23452-6546

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
2014016768MOMDOccupational Therapist
0119006854VAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1402963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679529600000",
    "number": "1588078687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "641 CARRIAGE HILL RD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234526546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "641 CARRIAGE HILL RD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234526546",
            "telephone_number": "757-263-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ALYCIA",
        "middle_name": "MARIE",
        "credential": "OTD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-17",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MO",
            "license": "2014016768",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "KS",
            "license": "17-02991",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "VA",
            "license": "0119006854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2023; 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.