Active NPI
Carol Poppe
- Behavior Technician
- Manassas, VA
National Provider Identifier
1912434200
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- OP-10-2017
- Practice address
- 10686 Crestwood Dr Ste B
Manassas, VA 20109-4407 - Phone
- (703) 392-6166
- Fax
- (703) 392-6166
- NPI assigned
- May 17, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | OP-10-2017 | VA | Primary |
Addresses
Primary practice location
10686 Crestwood Dr Ste B
Manassas, VA 20109-4407
Mailing address
2550 N Main St
Central Lake, MI 49622-9286
Phone (703) 479-6101
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
| License | State | Type | Specialty |
|---|---|---|---|
| OP-10-2017 | VA | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Leap Ahead, Inc. | Past | 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 and National Provider Directory roles.
-
- Early Intervention Provider Agency
- Manassas, VA
- NPI 1235381633
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1494979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1494979200000",
"number": "1912434200",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2550 N MAIN ST",
"city": "CENTRAL LAKE",
"state": "MI",
"postal_code": "496229286",
"telephone_number": "703-479-6101"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10686 CRESTWOOD DR STE B",
"city": "MANASSAS",
"state": "VA",
"postal_code": "201094407",
"telephone_number": "703-392-6166",
"fax_number": "703-392-6166"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POPPE",
"first_name": "CAROL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-05-17",
"last_updated": "2017-05-17",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "VA",
"license": "OP-10-2017",
"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 May 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.