Individual provider Active NPI

Silpa Mundru

  • Physical Medicine & Rehabilitation Physician
  • Fairfax, VA
National Provider Identifier
1679979876
Registry record updated Nov 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
2305204956 Issued in VA
Practice address
13053 Starling CT
Fairfax, VA 22033-3739
Phone
(571) 230-2782
Fax
(800) 985-9749
NPI assigned
Nov 15, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 2305204956 VA Primary

Addresses

Primary practice location

13053 Starling CT
Fairfax, VA 22033-3739

Mailing address

13053 Starling CT
Fairfax, VA 22033-3739
Phone (571) 230-2782

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
2305204956VAMDPhysical Medicine & Rehabilitation Physician

NPI Registry JSON

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

{
    "created_epoch": "1416009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416009600000",
    "number": "1679979876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13053 STARLING CT",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220333739",
            "telephone_number": "571-230-2782",
            "fax_number": "800-985-9749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13053 STARLING CT",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220333739",
            "telephone_number": "571-230-2782",
            "fax_number": "800-985-9749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNDRU",
        "first_name": "SILPA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-15",
        "last_updated": "2014-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "VA",
            "license": "2305204956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2014; 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.