Active NPI
VI Phan
- Occupational Therapy Assistant
- Gainesville, VA
National Provider Identifier
1750901104
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 0131001936
- Practice address
- 14935 Holly Knoll LN
Gainesville, VA 20155-4899 - Phone
- (703) 743-3999
- NPI assigned
- Apr 24, 2020
- Last updated
- Apr 24, 2020
- 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 |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 0131001936 | VA | Primary |
Addresses
Primary practice location
14935 Holly Knoll LN
Gainesville, VA 20155-4899
Mailing address
6143 Camerons Ferry Dr
Haymarket, VA 20169-3328
Phone (717) 507-6863
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 |
|---|---|---|---|
| 0131001936 | VA | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1587686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1587686400000",
"number": "1750901104",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6143 CAMERONS FERRY DR",
"city": "HAYMARKET",
"state": "VA",
"postal_code": "201693328",
"telephone_number": "717-507-6863"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14935 HOLLY KNOLL LN",
"city": "GAINESVILLE",
"state": "VA",
"postal_code": "201554899",
"telephone_number": "703-743-3999"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAN",
"first_name": "VI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-04-24",
"last_updated": "2020-04-24",
"certification_date": "2020-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "VA",
"license": "0131001936",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gainesville, VA
- Perioworks LLC
- Shabaan Pervaiz, DDS
- Zan Pervaiz, DDS
- Peter T Pham OD, PLLC (Dr. Peter T Pham & Associates)
- Peter Tien Dzung Pham, O.D.
- Pharmasutra PLLC (Gainesville Pharmacy)
- David Randell Phelps, APRN
- Phoenix Counselinggroup and Play Therapycenter, PLLC
- Phoenix Family Counseling & Play Therapy Center, PLLC
- Faline Phucas Davenport
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 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.