Active NPI
Susan Ammerman, PSYD
- Psychologist
- Fairfax, VA
National Provider Identifier
1689128407
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 0810005265
- Practice address
- 3020 Hamaker CT
Suite 103
Fairfax, VA 22031-2238 - Phone
- (703) 559-4098
- Fax
- (703) 876-1682
- NPI assigned
- Aug 10, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 0810005265 | VA | Primary |
Addresses
Primary practice location
3020 Hamaker CT
Suite 103
Fairfax, VA 22031-2238
Mailing address
3020 Hamaker CT
Suite 103
Fairfax, VA 22031-2238
Phone (703) 559-4098
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0810005265 | VA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1470787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1470787200000",
"number": "1689128407",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3020 HAMAKER CT",
"address_2": "SUITE 103",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220312238",
"telephone_number": "703-559-4098",
"fax_number": "703-876-1682"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3020 HAMAKER CT",
"address_2": "SUITE 103",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220312238",
"telephone_number": "703-559-4098",
"fax_number": "703-876-1682"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AMMERMAN",
"first_name": "SUSAN",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-08-10",
"last_updated": "2016-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "VA",
"license": "0810005265",
"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 Aug 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.