Individual provider Active NPI

Rana Bissat Roustom

  • Speech-Language Pathologist
  • Vienna, VA
National Provider Identifier
1972313625
Registry record updated Jan 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2202003827 Issued in VA
Practice address
2101 Robin Way CT
Vienna, VA 22182-5000
Phone
(703) 848-9491
Fax
(703) 848-9491
NPI assigned
Jan 13, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 2202003827 VA Primary

Addresses

Primary practice location

2101 Robin Way CT
Vienna, VA 22182-5000

Mailing address

2101 Robin Way CT
Vienna, VA 22182-5000
Phone (703) 848-9491

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
2202003827VAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1736726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736726400000",
    "number": "1972313625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 ROBIN WAY CT",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221825000",
            "telephone_number": "703-848-9491",
            "fax_number": "703-848-9491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 ROBIN WAY CT",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221825000",
            "telephone_number": "703-848-9491",
            "fax_number": "703-848-9491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUSTOM",
        "first_name": "RANA",
        "middle_name": "BISSAT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-13",
        "last_updated": "2025-01-13",
        "certification_date": "2025-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202003827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vienna, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2025; 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.