NPIMap

Individual provider Active NPI

Heather Marie Tavares, OTR L

  • Occupational Therapist
  • Springfield, VA
National Provider Identifier
1609850387
Registry record updated Feb 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
0119003116 Issued in VA
Practice address
6506 Loisdale Rd
Ste 300
Springfield, VA 22150
Phone
(703) 924-4100
Fax
(703) 922-0638
NPI assigned
Dec 6, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2012

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 0119003116 VA Primary
Occupational Therapist 225X00000X OT010000316 DC

Addresses

Primary practice location

6506 Loisdale Rd
Ste 300
Springfield, VA 22150

Mailing address

25893 Donovan Dr
Chantilly, VA 20152
Phone (703) 957-4268

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

LicenseStateTypeSpecialty
OT010000316DCMDOccupational Therapist
0119003116VAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329696000000",
    "number": "1609850387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25893 DONOVAN DR",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "20152",
            "telephone_number": "703-957-4268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6506 LOISDALE RD",
            "address_2": "STE 300",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "22150",
            "telephone_number": "703-924-4100",
            "fax_number": "703-922-0638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAVARES",
        "first_name": "HEATHER",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "OTR L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-06",
        "last_updated": "2012-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "VA",
            "license": "0119003116",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "DC",
            "license": "OT010000316",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2012; 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.