Individual provider Active NPI

Kieifi A Myrick, OT

  • Occupational Therapist
  • Herndon, VA
National Provider Identifier
1669033197
Registry record updated Jun 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
0119008122 Issued in VA
Practice address
102 Elden St Ste 12
Herndon, VA 20170-4839
Phone
(703) 587-8999
NPI assigned
Jun 25, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 0119008122 VA Primary

Addresses

Primary practice location

102 Elden St Ste 12
Herndon, VA 20170-4839

Mailing address

5252 Lyngate CT Ste 203
Burke, VA 22015-1673
Phone (703) 239-2300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230626000814 DC Practitioner - Occupational Therapist in Private Practice 2365800240 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Creative Health Care Management LLC Occupational Therapist CurrentSince Jun 1, 2023 Accepting new patients
Creative Health Care Management, LLC Occupational Therapist CurrentSince Jun 1, 2023 Accepting new patients
Hand Therapy Experts, LLC Occupational Therapist Past Accepting new patients
Alliance Rehab and Physical Therapy LLC Past Accepting new patients

Locations

10 S 9th St
Ste 4
Noblesville, IN 46060

Organizations & group practices 9

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.

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Creative Health Care Management LLC 87 clinicians

Practice addresses (Care Compare)

4656 Livingston Rd SE
Vertis Therapy|Livingston Place
Washington, DC 20032-3136
Phone (202) 519-0982

NPI Registry JSON

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

{
    "created_epoch": "1561420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561420800000",
    "number": "1669033197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5252 LYNGATE CT STE 203",
            "city": "BURKE",
            "state": "VA",
            "postal_code": "220151673",
            "telephone_number": "703-239-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 ELDEN ST STE 12",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201704839",
            "telephone_number": "703-587-8999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYRICK",
        "first_name": "KIEIFI",
        "middle_name": "A",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-25",
        "last_updated": "2019-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "VA",
            "license": "0119008122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Herndon, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.