Individual provider Active NPI

Trista M Metzler, OTRL

  • Occupational Therapist
  • Stafford, VA
National Provider Identifier
1831421692
Registry record updated Aug 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
0019007187 Issued in VA
Practice address
2777 Richmond Hwy Ste 109
Stafford, VA 22554-8323
Phone
(403) 188-6155
Fax
(540) 318-8619
NPI assigned
Feb 4, 2010
Last updated
Aug 11, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OTR-809 WY
Occupational Therapist 225X00000X 0019007187 VA Primary

Addresses

Primary practice location

2777 Richmond Hwy Ste 109
Stafford, VA 22554-8323

Mailing address

PO Box 791217
Baltimore, MD 21279-1217
Phone (301) 932-4785

Other practice location 1

620 4J Ct
Gillette, WY 82716-4130
Phone (307) 686-2569

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230822003566 VA Practitioner - Occupational Therapist in Private Practice 7618012659 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Proflex Physical Therapy of Maryland, LLCGroup PAC ID 7416244322, 41 clinicians

Practice addresses (Care Compare)

2777 Richmond Hwy
Suite 109
Stafford, VA 22554-8323
Phone (540) 318-8615

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0019007187VAMDOccupational Therapist
OTR-809WYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Proflex Physical Therapy of Maryland, LLC. CurrentSince Aug 1, 2023 Accepting new patients
Proflex Physical Thearpy of Maryland, LLC CurrentSince Aug 1, 2023 Accepting new patients
North Platte Physical Therapy Services Inc Past Accepting new patients
North Platte Physical Therapy Services, Inc. PastSince Jun 1, 2000 Accepting new patients
Holistic Pain Management of Wyoming, LLC Past Accepting new patients
William H and Carrie Gottsche Foundation PastSince Nov 1, 2005 Accepting new patients

Locations

2777 Richmond Hwy
Ste 109
Stafford, VA 22554
Phone (540) 318-8615

Organizations & group practices 6

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": "1265241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691712000000",
    "number": "1831421692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 791217",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212791217",
            "telephone_number": "301-932-4785",
            "fax_number": "301-932-4789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2777 RICHMOND HWY STE 109",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225548323",
            "telephone_number": "403-188-6155",
            "fax_number": "540-318-8619"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "620 4J Ct",
            "address_purpose": "LOCATION",
            "city": "Gillette",
            "state": "WY",
            "postal_code": "827164130",
            "country_code": "US",
            "telephone_number": "307-686-2569",
            "fax_number": "307-686-2615",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "METZLER",
        "first_name": "TRISTA",
        "middle_name": "M",
        "credential": "OTRL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-04",
        "last_updated": "2023-08-11",
        "certification_date": "2023-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WY",
            "license": "OTR-809",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "VA",
            "license": "0019007187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stafford, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2023; 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.