Active NPI
Vivian Lee Muccio
- Audiologist
- Fairfax, VA
National Provider Identifier
1760624191
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 2201000224
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 2201000224 | VA | MD | Audiologist |
| 2101000549 | VA | MD | Audiologist-Hearing Aid Fitter |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hearing Solutions of Fairfax PC | Audiologist-Hearing Aid Fitter | 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.
-
- Audiologist-Hearing Aid Fitter
- Fairfax, VA
- NPI 1538408240
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.