Individual provider Active NPI

Vivian Lam

  • Optometrist
  • Chantilly, VA
National Provider Identifier
1982594586
Registry record updated Jul 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0618003536 Issued in VA
Practice address
25055 Riding PLZ Ste 100
Chantilly, VA 20152-5918
Phone
(703) 957-3384
Fax
(703) 957-3387
NPI assigned
Jul 7, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Low Vision Rehabilitation Optometrist 152WL0500X 0618003536 VA
Pediatric Optometrist 152WP0200X 0618003536 VA
Optometrist 152W00000X 0618003536 VA Primary

Addresses

Primary practice location

25055 Riding PLZ Ste 100
Chantilly, VA 20152-5918

Mailing address

25055 Riding PLZ Ste 100
Chantilly, VA 20152-5918
Phone (703) 957-3384

Other practice location 1

21001 Sycolin Rd Ste 140
Ashburn, VA 20147-4074
Phone (703) 722-8688

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
0618003536VAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Optometric Consultants of Virginia, Inc Optometrist CurrentSince Jun 6, 2012 Accepting new patients

Locations

21001 Sycolin Rd
Ste 140
Ashburn, VA 20147
Phone (703) 722-8688

5511 Merchants View Sq
Haymarket, VA 20169
Phone (703) 659-4430

25055 Riding Plz
Ste 100
South Riding, VA 20152
Phone (703) 957-3384

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.

NPI Registry JSON

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

{
    "created_epoch": "1751846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751846400000",
    "number": "1982594586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25055 RIDING PLZ STE 100",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201525918",
            "telephone_number": "703-957-3384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25055 RIDING PLZ STE 100",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201525918",
            "telephone_number": "703-957-3384",
            "fax_number": "703-957-3387"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21001 Sycolin Rd Ste 140",
            "address_purpose": "LOCATION",
            "city": "Ashburn",
            "state": "VA",
            "postal_code": "201474074",
            "country_code": "US",
            "telephone_number": "703-722-8688",
            "fax_number": "703-957-3387",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAM",
        "first_name": "VIVIAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-07",
        "last_updated": "2025-07-07",
        "certification_date": "2025-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "VA",
            "license": "0618003536",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "VA",
            "license": "0618003536",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618003536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chantilly, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 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.