Individual provider Active NPI

Amy Wilson Burger

  • Speech-Language Pathologist
  • Woodbridge, VA
National Provider Identifier
1629579883
Registry record updated Feb 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2203003635 Issued in VA
Practice address
3001 Old Bridge Rd
Woodbridge, VA 22192-3221
Phone
(703) 497-8000
NPI assigned
Feb 23, 2018
Last updated
Feb 23, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 2203003635 VA Primary

Addresses

Primary practice location

3001 Old Bridge Rd
Woodbridge, VA 22192-3221

Mailing address

6704 Harwood PL
Springfield, VA 22152-2419

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
2203003635VAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1519344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519344000000",
    "number": "1629579883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6704 HARWOOD PL",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "221522419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 OLD BRIDGE RD",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221923221",
            "telephone_number": "703-497-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGER",
        "first_name": "AMY",
        "middle_name": "WILSON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-23",
        "last_updated": "2018-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2203003635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2018; 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.