Individual provider Active NPI

Yvonne Dreptate, LMT

  • Massage Therapist
  • Fairfax, VA
National Provider Identifier
1871948315
Registry record updated May 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
0019007455 Issued in VA
Practice address
2985 District Ave
Fairfax, VA 22031-1541
Phone
(443) 406-8339
NPI assigned
May 3, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 3, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 0019007455 VA Primary
Massage Therapist 225700000X MT107551 TX
Massage Therapist 225700000X MD # R02177 MD

Addresses

Primary practice location

2985 District Ave
Fairfax, VA 22031-1541

Mailing address

2985 District Ave
Unit 687
Fairfax, VA 22031-1541
Phone (570) 730-1953

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
MD # R02177MDMDMassage Therapist
MT107551TXMDMassage Therapist
0019007455VAMDMassage Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1462233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462233600000",
    "number": "1871948315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2985 DISTRICT AVE",
            "address_2": "UNIT 687",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220311541",
            "telephone_number": "570-730-1953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2985 DISTRICT AVE",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220311541",
            "telephone_number": "443-406-8339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DREPTATE",
        "first_name": "YVONNE",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-03",
        "last_updated": "2016-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "VA",
            "license": "0019007455",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "TX",
            "license": "MT107551",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "MD",
            "license": "MD # R02177",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2016; 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.