Active NPI
Vienna Brummond, OTR/L
- Occupational Therapist
- Fredericksburg, VA
National Provider Identifier
1811630171
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 0119009419
- Practice address
- 55 Brimley Dr
Fredericksburg, VA 22406 - Phone
- (540) 701-9480
- NPI assigned
- Apr 15, 2022
- Last updated
- Mar 6, 2025
- 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 | 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
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
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0119009419 | VA | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Primus Physical Therapy Fairfax | Current | Accepting new patients | |
| Primus Physical Therapy | Current | 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.
-
- Physical Therapy Clinic/Center
- Fairfax, VA
- NPI 1104461441
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.