Individual provider Active NPI

Danica D Palmer, MD..

  • Psychiatry Physician
  • Reston, VA
National Provider Identifier
1972794931
Registry record updated Jun 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
0101232641 Issued in VA
Practice address
1850 Cameron Glen Dr
#600
Reston, VA 20190-3363
Phone
(703) 481-4100
Fax
(703) 435-1961
NPI assigned
Aug 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 0101232641 VA Primary

Addresses

Primary practice location

1850 Cameron Glen Dr
#600
Reston, VA 20190-3363

Mailing address

1850 Cameron Glen Dr
#600
Reston, VA 20190-3363
Phone (703) 481-4100

Other practice location 1

4850 Mark Center Dr
Alexandria, VA 22311-1882
Phone (703) 746-3400

Other identifiers 1

IdentifierTypeStateIssuer
004945107MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040205001247 DC Practitioner - Psychiatry 3173416898 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
City of AlexandriaGroup PAC ID 0941195374, 27 clinicians

Practice addresses (Care Compare)

4850 Mark Ctr Dr
Alexandria, VA 22311-1882
Phone (703) 746-3400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101232641VAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
City of Alexandria CurrentSince Oct 8, 2016 Accepting new patients
City of Alexandria CurrentSince Oct 8, 2016 Accepting new patients
Fairfax County, Virginia PastSince Mar 1, 2021 Accepting new patients

Locations

720 N Saint Asaph St
Alexandria, VA 22314
Phone (703) 746-3400

4850 Mark Center Dr
Alexandria, VA 22311
Phone (703) 746-3400

4850 Mark Center Dr
Fl 9
Alexandria, VA 22311
Phone (703) 746-3400

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1186358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1972794931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 CAMERON GLEN DR",
            "address_2": "#600",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201903363",
            "telephone_number": "703-481-4100",
            "fax_number": "703-435-1961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 CAMERON GLEN DR",
            "address_2": "#600",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201903363",
            "telephone_number": "703-481-4100",
            "fax_number": "703-435-1961"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4850 Mark Center Dr",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "VA",
            "postal_code": "223111882",
            "country_code": "US",
            "telephone_number": "703-746-3400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PALMER",
        "first_name": "DANICA",
        "middle_name": "D",
        "credential": "MD..",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-06",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0101232641",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004945107",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reston, VA

Sources for this page

Verify at the official NPI Registry.