Individual provider Active NPI

William Walter Commins, PSY. D.

  • Psychologist
  • Burke, VA
National Provider Identifier
1770637621
Registry record updated Dec 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
0810001550 Issued in VA
Practice address
8996 Burke Lake Rd Ste 300
Burke, VA 22015-1607
Phone
(703) 323-5551
Fax
(703) 323-5551
NPI assigned
Jan 22, 2007
Last updated
Dec 8, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 0810001550 VA Primary

Addresses

Primary practice location

8996 Burke Lake Rd Ste 300
Burke, VA 22015-1607

Mailing address

8996 Burke Lake Rd Ste 300
Burke, VA 22015-1607
Phone (703) 323-5551

Other identifiers 1

IdentifierTypeStateIssuer
7750480MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090721000448 DC Practitioner - Clinical Psychologist 4385791441 Practice locations: Burke, VA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8996 Burke Lake Rd
Burke, VA 22015-1607
Phone (703) 323-5551

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0810001550VAMDPsychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228694400000",
    "number": "1770637621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8996 BURKE LAKE RD STE 300",
            "city": "BURKE",
            "state": "VA",
            "postal_code": "220151607",
            "telephone_number": "703-323-5551",
            "fax_number": "703-323-5551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8996 BURKE LAKE RD STE 300",
            "city": "BURKE",
            "state": "VA",
            "postal_code": "220151607",
            "telephone_number": "703-323-5551",
            "fax_number": "703-323-5551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COMMINS",
        "first_name": "WILLIAM",
        "middle_name": "WALTER",
        "name_prefix": "Dr.",
        "credential": "PSY. D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2008-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "VA",
            "license": "0810001550",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7750480",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burke, VA

Sources for this page

Verify at the official NPI Registry.