Madison Eagen, BCBA, LBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

0133001686 Issued in VA

Practice address

11576 Greenwich Point Rd
Reston, VA 20194-1200

Phone

(703) 303-3902

NPI assigned

Mar 28, 2020

Last updated

Mar 28, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1585353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585353600000",
    "number": "1710515531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11576 GREENWICH POINT RD",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201941200",
            "telephone_number": "703-303-3902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11576 GREENWICH POINT RD",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201941200",
            "telephone_number": "703-303-3902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EAGEN",
        "first_name": "MADISON",
        "credential": "BCBA, LBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-28",
        "last_updated": "2020-03-28",
        "certification_date": "2020-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "VA",
            "license": "0133001686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "REST",
            "endpointTypeDescription": "RESTful URL",
            "endpoint": "IntakeQ",
            "affiliation": "N",
            "endpointDescription": "HTTP endpoints that can be reached through a REST API",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "other",
            "address_1": "11576 Greenwich Point Rd",
            "city": "Reston",
            "state": "VA",
            "country_code": "US",
            "postal_code": "201941200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Shaina Duvall, RD
• James Michael Dwyer, RPH
• Charles E Dyer, MD
• Ea Dental (Reston Dental Care)
• Sandra J Eaddy, CRNA
• Anne Rose Navarro Eapen, M.D.
• Richard James Edgar, MD
• Phebe Edillon, OTD, OTR/L
• Alicia Edwards
• Kathleen Egan, CCC-SLP, BCBA

• Behavior Analyst in Reston, VA
• Providers in Reston, VA by specialty
• Behavior Analyst in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2020; 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.