Individual provider Active NPI

Tammy Lynn Phipps, OTR

  • Driving and Community Mobility Occupational Therapist
  • Chantilly, VA
National Provider Identifier
1619185139
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Driving and Community Mobility Occupational TherapistTaxonomy code 225XR0403X
License
0119006366 Issued in VA
Practice address
14101 Parke Long CT
Chantilly, VA 20151-1645
Phone
(605) 380-6993
NPI assigned
May 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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 0538 SD
Driving and Community Mobility Occupational Therapist 225XR0403X 0119006366 VA Primary

Addresses

Primary practice location

14101 Parke Long CT
Chantilly, VA 20151-1645

Mailing address

12154 Wedgeway CT
Fairfax, VA 22033-2514
Phone (605) 380-6993

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0538SDMDMOHS-Micrographic Surgery Physician
0119006366VAMDDriving and Community Mobility Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Driver Rehabilitation Center of Excellence, LLC Occupational Therapist Current 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.

NPI Registry JSON

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1619185139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12154 WEDGEWAY CT",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220332514",
            "telephone_number": "605-380-6993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14101 PARKE LONG CT",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201511645",
            "telephone_number": "605-380-6993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHIPPS",
        "first_name": "TAMMY",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-18",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "SD",
            "license": "0538",
            "primary": false
        },
        {
            "code": "225XR0403X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Driving and Community Mobility",
            "state": "VA",
            "license": "0119006366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chantilly, VA

Sources for this page

Verify at the official NPI Registry.