Active NPI
Tracey Sue Yost, OTR/L
- Pediatric Occupational Therapist
- Centreville, VA
National Provider Identifier
1962453035
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- 0119004309
- Practice address
- 14101 Rock Canyon Dr
Centreville, VA 20121 - Phone
- (937) 716-4389
- NPI assigned
- May 13, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 0119004309 | VA | Primary |
Addresses
Primary practice location
14101 Rock Canyon Dr
Centreville, VA 20121
Mailing address
14101 Rock Canyon Dr
Centreville, VA 20121-3860
Phone (937) 716-4389
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 |
|---|---|---|---|
| 0119004309 | VA | MD | Pediatric Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147478400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1532304000000",
"number": "1962453035",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14101 ROCK CANYON DR",
"city": "CENTREVILLE",
"state": "VA",
"postal_code": "201213860",
"telephone_number": "937-716-4389"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14101 ROCK CANYON DR",
"city": "CENTREVILLE",
"state": "VA",
"postal_code": "20121",
"telephone_number": "937-716-4389"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOST",
"first_name": "TRACEY",
"middle_name": "SUE",
"name_prefix": "Mrs.",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-05-13",
"last_updated": "2018-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Occupational Therapist, Pediatrics",
"state": "VA",
"license": "0119004309",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Centreville, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.