Active NPI
Rebecca Michelle Mattox
- Behavior Technician
- Fairfax, VA
National Provider Identifier
1750145223
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- T63899493
- Practice address
- 11200 Waples Mill Rd
Fairfax, VA 22030-7407 - Phone
- (703) 237-2219
- NPI assigned
- Feb 6, 2024
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | T63899493 | VA | Primary |
Addresses
Primary practice location
11200 Waples Mill Rd
Fairfax, VA 22030-7407
Mailing address
9100 Weathersfield Dr
Bristow, VA 20136-1786
Phone (913) 702-8780
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 |
|---|---|---|---|
| T63899493 | VA | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Axiom Link, Inc. | Behavior Technician | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1707177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707177600000",
"number": "1750145223",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9100 WEATHERSFIELD DR",
"city": "BRISTOW",
"state": "VA",
"postal_code": "201361786",
"telephone_number": "913-702-8780"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11200 WAPLES MILL RD",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220307407",
"telephone_number": "703-237-2219"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATTOX",
"first_name": "REBECCA",
"middle_name": "MICHELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-02-06",
"last_updated": "2024-02-06",
"certification_date": "2024-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "VA",
"license": "T63899493",
"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 Feb 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.