Individual provider Active NPI

Mary Mozingo, RBT

  • Behavior Technician
  • Manassas, VA
National Provider Identifier
1720561848
Registry record updated Sep 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-17-29712 Issued in VA
Practice address
7653 Callan Dr
Manassas, VA 20109-2901
Phone
(571) 408-1616
NPI assigned
Sep 13, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-17-29712 VA Primary

Addresses

Primary practice location

7653 Callan Dr
Manassas, VA 20109-2901

Mailing address

7653 Callan Dr
Manassas, VA 20109-2901
Phone (571) 408-1616

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

LicenseStateTypeSpecialty
RBT-17-29712VAMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1536796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536796800000",
    "number": "1720561848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7653 CALLAN DR",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201092901",
            "telephone_number": "571-408-1616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7653 CALLAN DR",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201092901",
            "telephone_number": "571-408-1616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOZINGO",
        "first_name": "MARY",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-13",
        "last_updated": "2018-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "VA",
            "license": "RBT-17-29712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manassas, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2018; 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.