Individual provider Active NPI

Vivian Lee Muccio

  • Audiologist
  • Fairfax, VA
National Provider Identifier
1760624191
Registry record updated Jan 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
2201000224 Issued in VA
Practice address
3930 Pender Dr Ste 140
Fairfax, VA 22030-0986
Phone
(571) 432-0640
NPI assigned
Mar 31, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 2201000224 VA Primary
Audiologist-Hearing Aid Fitter 237600000X 2101000549 VA

Addresses

Primary practice location

3930 Pender Dr Ste 140
Fairfax, VA 22030-0986

Mailing address

1320 Old Chain Bridge Rd Ste 185
MC Lean, VA 22101-3945
Phone (703) 866-8819

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
2201000224VAMDAudiologist
2101000549VAMDAudiologist-Hearing Aid Fitter

Practice roles

OrganizationSpecialtyStatusNew patients
Hearing Solutions of Fairfax PC Audiologist-Hearing Aid Fitter PastSince Jan 19, 2020 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": "1238457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579132800000",
    "number": "1760624191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 OLD CHAIN BRIDGE RD STE 185",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221013945",
            "telephone_number": "703-866-8819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3930 PENDER DR STE 140",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220300986",
            "telephone_number": "571-432-0640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUCCIO",
        "first_name": "VIVIAN",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-31",
        "last_updated": "2020-01-16",
        "certification_date": "2020-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "VA",
            "license": "2201000224",
            "primary": true
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "VA",
            "license": "2101000549",
            "primary": false
        }
    ],
    "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 Jan 16, 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.