Individual provider Active NPI

Mary M. Hansford

  • Speech-Language Pathologist
  • Manassas, VA
National Provider Identifier
1861981615
Registry record updated Nov 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2202004629 Issued in VA
Practice address
14715 Bristow Rd
Manassas, VA 20112-3945
Phone
(703) 594-3990
NPI assigned
May 8, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 2202004629 VA Primary

Addresses

Primary practice location

14715 Bristow Rd
Manassas, VA 20112-3945

Mailing address

14715 Bristow Rd
Manassas, VA 20112-3945

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20251024001442 VA Practitioner - Qualified Speech Language Pathologist 1153819735 Reassigns benefits to 1 organization
I20260112000000 DC Practitioner - Qualified Speech Language Pathologist 1153819735 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Functional Pathways Preferred of Tennessee LLCGroup PAC ID 2860649654, 194 clinicians

Practice addresses (Care Compare)

12052 N Shore Dr
Reston, VA 20190-4969
Phone (888) 531-2204

1600 Westwood Ave
Richmond, VA 23227-4622
Phone (888) 531-2204

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2202004629VAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Functional Pathways Preferred of Tennessee LLC Speech-Language Pathologist CurrentSince Aug 30, 2025 Accepting new patients

Locations

10133 Sherrill Blvd
Ste 200
Knoxville, TN 37932
Phone (865) 392-2847

1600 Westwood Ave
Richmond, VA 23227
Phone (804) 355-5721

1410 N Augusta St
#A
Staunton, VA 24401

3317 Ocean Shore Ave
Virginia Beach, VA 23451
Phone (757) 232-3179

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": "1525737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762128000000",
    "number": "1861981615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14715 BRISTOW RD",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201123945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14715 BRISTOW RD",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201123945",
            "telephone_number": "703-594-3990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSFORD",
        "first_name": "MARY",
        "middle_name": "M.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-08",
        "last_updated": "2025-11-03",
        "certification_date": "2025-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202004629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manassas, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 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.