Individual provider Active NPI

Ivone Corvalan Osborne, CMT

  • Massage Therapist
  • Fairfax, VA
National Provider Identifier
1912155425
Registry record updated Sep 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
0019005149 Issued in VA
Practice address
8550 Arlington Blvd Ste 325
Fairfax, VA 22031-4647
Phone
(703) 698-7117
Fax
(703) 698-5729
NPI assigned
Sep 9, 2008
Last updated
Sep 9, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 0019005149 VA Primary

Addresses

Primary practice location

8550 Arlington Blvd Ste 325
Fairfax, VA 22031-4647

Mailing address

11441 Fogarty CT
Fairfax, VA 22030-8555
Phone (240) 476-8224

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
0019005149VAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Multi Discipline Alternative Care Center, LTD PastSince Feb 4, 2012 Accepting new patients

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, 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": "1220918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220918400000",
    "number": "1912155425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11441 FOGARTY CT",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220308555",
            "telephone_number": "240-476-8224",
            "fax_number": "703-272-7579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8550 ARLINGTON BLVD STE 325",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314647",
            "telephone_number": "703-698-7117",
            "fax_number": "703-698-5729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSBORNE",
        "first_name": "IVONE",
        "middle_name": "CORVALAN",
        "name_prefix": "Mrs.",
        "credential": "CMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-09",
        "last_updated": "2008-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "VA",
            "license": "0019005149",
            "primary": true
        }
    ],
    "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 Sep 9, 2008; 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.