Individual provider Active NPI

Samantha Sheppard Thompson, BCBA, LBA

  • Behavior Analyst
  • Sterling, VA
National Provider Identifier
1811579550
Registry record updated Apr 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
0133001976 Issued in VA
Practice address
21680 Ridgetop Cir Ste 100
Sterling, VA 20166-4292
Phone
(703) 689-0019
NPI assigned
Apr 22, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 0133001976 VA Primary

Addresses

Primary practice location

21680 Ridgetop Cir Ste 100
Sterling, VA 20166-4292

Mailing address

21329 Marcum Farm CT
Leesburg, VA 20175-6201
Phone (703) 785-8531

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

LicenseStateTypeSpecialty
0133001976VAMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Autism Outreach Inc. Behavior Analyst CurrentSince Apr 25, 2021 Accepting new patients

Locations

21680 Ridgetop Cir
Ste 100
Sterling, VA 20166
Phone (703) 689-0019

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": "1619049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619049600000",
    "number": "1811579550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21329 MARCUM FARM CT",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201756201",
            "telephone_number": "703-785-8531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21680 RIDGETOP CIR STE 100",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201664292",
            "telephone_number": "703-689-0019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "SAMANTHA",
        "middle_name": "SHEPPARD",
        "credential": "BCBA, LBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-22",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "VA",
            "license": "0133001976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2021; 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.