Individual provider Active NPI

Madison Carmichael, OT LICENSE APPLICANT

  • Occupational Therapist
  • Reston, VA
National Provider Identifier
1679353767
Registry record updated Jan 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
1860 Town Center Dr
Reston, VA 20190-5896
Phone
(703) 435-6604
NPI assigned
Oct 5, 2023
Last updated
Jan 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2025

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 NU Primary

Addresses

Primary practice location

1860 Town Center Dr
Reston, VA 20190-5896

Mailing address

8164 Ships Curve LN
Springfield, VA 22153-1838

Other practice location 1

11166 Fairfax Blvd
Fairfax, VA 22030-5017
Phone (703) 435-6604

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240311000995 DC Practitioner - Occupational Therapist in Private Practice 0941646129 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1860 Town Ctr Dr
Suite 300
Reston, VA 20190-5900
Phone (703) 435-6604

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Town Center Orthopaedic Associates PC CurrentSince Mar 11, 2024 Accepting new patients
Town Center Orthopaedic Associates, P.C. Occupational Therapist CurrentSince Mar 11, 2024 Accepting new patients

Locations

1860 Town Center Dr
Ste 300
Reston, VA 20190
Phone (703) 483-4684

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1696464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737417600000",
    "number": "1679353767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8164 SHIPS CURVE LN",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "221531838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1860 TOWN CENTER DR",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201905896",
            "telephone_number": "703-435-6604"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11166 Fairfax Blvd",
            "address_purpose": "LOCATION",
            "city": "Fairfax",
            "state": "VA",
            "postal_code": "220305017",
            "country_code": "US",
            "telephone_number": "703-435-6604",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARMICHAEL",
        "first_name": "MADISON",
        "credential": "OT LICENSE APPLICANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-05",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reston, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2025; 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.