Active NPI
Shanika Udumalagala
- Behavior Technician
- Fairfax, VA
National Provider Identifier
1609693886
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 11200 Waples Mill Rd Ste 100
Fairfax, VA 22030-7475 - Phone
- (703) 237-2219
- NPI assigned
- Sep 20, 2024
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
11200 Waples Mill Rd Ste 100
Fairfax, VA 22030-7475
Mailing address
6200 Wilson Blvd Apt 510
Falls Church, VA 22044-3205
Phone (571) 501-6420
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Axiom Link, Inc. | Behavior Technician | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Achieve Beyond
- Rehabilitation Clinic/Center
- Fairfax, VA
- NPI 1174852867
Behavior Technician
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1726790400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726790400000",
"number": "1609693886",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6200 WILSON BLVD APT 510",
"city": "FALLS CHURCH",
"state": "VA",
"postal_code": "220443205",
"telephone_number": "571-501-6420"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11200 WAPLES MILL RD STE 100",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220307475",
"telephone_number": "703-237-2219"
}
],
"practiceLocations": [],
"basic": {
"last_name": "UDUMALAGALA",
"first_name": "SHANIKA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-09-20",
"last_updated": "2024-09-20",
"certification_date": "2024-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"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 Sep 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.