Active NPI
Shweta Krishnan Iyengar, OT
- Occupational Therapist
- Fairfax, VA
National Provider Identifier
1760795264
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 06336
- Practice address
- 11200 Waples Mill Rd Ste 100
Fairfax, VA 22030-7475 - Phone
- (703) 237-2219
- NPI assigned
- Jul 26, 2010
- Last updated
- Oct 20, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 Therapist | 225X00000X | 06336 | MD | Primary |
Addresses
Primary practice location
11200 Waples Mill Rd Ste 100
Fairfax, VA 22030-7475
Mailing address
8033 Tyson Oaks Cir
Vienna, VA 22182-3941
Phone (716) 425-6047
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 |
|---|---|---|---|
| 06336 | MD | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Axiom Link, Inc. | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1280102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729382400000",
"number": "1760795264",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8033 TYSON OAKS CIR",
"city": "VIENNA",
"state": "VA",
"postal_code": "221823941",
"telephone_number": "716-425-6047"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11200 WAPLES MILL RD STE 100",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220307475",
"telephone_number": "703-237-2219"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IYENGAR",
"first_name": "SHWETA",
"middle_name": "KRISHNAN",
"name_prefix": "Ms.",
"credential": "OT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-07-26",
"last_updated": "2024-10-20",
"certification_date": "2024-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MD",
"license": "06336",
"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 Oct 20, 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.