Individual provider Active NPI

Vienna Brummond, OTR/L

  • Occupational Therapist
  • Fredericksburg, VA
National Provider Identifier
1811630171
Registry record updated Mar 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
0119009419 Issued in VA
Practice address
55 Brimley Dr
Fredericksburg, VA 22406
Phone
(540) 701-9480
NPI assigned
Apr 15, 2022
Last updated
Mar 6, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 0119009419 VA Primary

Addresses

Primary practice location

55 Brimley Dr
Fredericksburg, VA 22406

Mailing address

15907 Cranberry CT
Dumfries, VA 22025-1708
Phone (571) 221-4160

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241120001637 DC Practitioner - Occupational Therapist in Private Practice 8921533597 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Primus Physical TherapyGroup PAC ID 4789981564, 6 clinicians

Practice addresses (Care Compare)

6101 Redwood Square Ctr
Suite 202
Centreville, VA 20121-4269
Phone (703) 543-6660

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0119009419VAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Primus Physical Therapy Fairfax CurrentSince Nov 5, 2024 Accepting new patients
Primus Physical Therapy CurrentSince Nov 5, 2024 Accepting new patients

Locations

6101 Redwood Square Ctr
Ste 202
Centreville, VA 20121
Phone (703) 543-6660

Organizations & group practices 2

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": "1649980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741219200000",
    "number": "1811630171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15907 CRANBERRY CT",
            "city": "DUMFRIES",
            "state": "VA",
            "postal_code": "220251708",
            "telephone_number": "571-221-4160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 BRIMLEY DR",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "22406",
            "telephone_number": "540-701-9480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUMMOND",
        "first_name": "VIENNA",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-15",
        "last_updated": "2025-03-06",
        "certification_date": "2025-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "VA",
            "license": "0119009419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.