Individual provider Active NPI

Beth Kyarayende Pottridge

  • Developmentally Disabled Services Day Training Agency
  • Fredericksburg, VA
National Provider Identifier
1962315689
Registry record updated Sep 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
Practice address
12311 Willow Woods Dr
Fredericksburg, VA 22407-6695
Phone
(817) 676-5185
NPI assigned
Sep 24, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X VA Primary

Addresses

Primary practice location

12311 Willow Woods Dr
Fredericksburg, VA 22407-6695

Mailing address

12311 Willow Woods Dr
Fredericksburg, VA 22407-6695
Phone (817) 676-5185

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1790208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790208000000",
    "number": "1962315689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12311 WILLOW WOODS DR",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224076695",
            "telephone_number": "817-676-5185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12311 WILLOW WOODS DR",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224076695",
            "telephone_number": "817-676-5185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTRIDGE",
        "first_name": "BETH",
        "middle_name": "KYARAYENDE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-09-24",
        "last_updated": "2026-09-24",
        "certification_date": "2026-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.