Individual provider Active NPI

Laura Fitzpatrick

  • Developmental Therapist
  • Manassas, VA
National Provider Identifier
1891179859
Registry record updated Jul 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental TherapistTaxonomy code 222Q00000X
License
PGP-0657774 Issued in VA
Practice address
8059 Stillbrooke Rd
Manassas, VA 20112-4602
Phone
(785) 447-2941
NPI assigned
Jul 18, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Therapist 222Q00000X PGP-0657774 VA Primary

Addresses

Primary practice location

8059 Stillbrooke Rd
Manassas, VA 20112-4602

Mailing address

8059 Stillbrooke Rd
Manassas, VA 20112-4602
Phone (785) 447-2941

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
PGP-0657774VAMDDevelopmental Therapist

NPI Registry JSON

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

{
    "created_epoch": "1437177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437177600000",
    "number": "1891179859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8059 STILLBROOKE RD",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201124602",
            "telephone_number": "785-447-2941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8059 STILLBROOKE RD",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201124602",
            "telephone_number": "785-447-2941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZPATRICK",
        "first_name": "LAURA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-18",
        "last_updated": "2015-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": "VA",
            "license": "PGP-0657774",
            "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 Jul 18, 2015; 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.