Basic Information
Provider Information | |||||||||
NPI: | 1801839782 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | ANTOINE | ||||||||
FirstName: | MARGARET | ||||||||
MiddleName: | M | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | M.S. C.H.T | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 1115 BOULDERS PKWY | ||||||||
Address2: | SUITE 200 | ||||||||
City: | NORTH CHESTERFIELD | ||||||||
State: | VA | ||||||||
PostalCode: | 232254067 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8045605595 | ||||||||
FaxNumber: | 8045609029 | ||||||||
Practice Location | |||||||||
Address1: | 7650 E PARHAM RD | ||||||||
Address2: | SUITE 100 | ||||||||
City: | RICHMOND | ||||||||
State: | VA | ||||||||
PostalCode: | 232944373 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8042826338 | ||||||||
FaxNumber: | 8042853237 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 06/14/2006 | ||||||||
LastUpdateDate: | 02/01/2013 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225XH1200X | 01190000130 | VA | N |   | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Hand | 225X00000X | 0119000130 | VA | Y |   | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |   |
ID Information
ID | Type | State | Issuer | Description | 540885859 | 01 | VA | FIRST HEALTH/CCN | OTHER | 98999 | 01 | VA | OPTIMA HEALTH | OTHER | 2224092 | 01 | VA | AETNA HMO | OTHER | 540885859 | 01 | VA | CIGNA REHAB OT | OTHER | 194768 | 01 | VA | ANTHEM OT | OTHER | 540885859 | 01 | VA | C&O EMPLOYEE'S HEALTHCARE | OTHER | 540885859 | 01 | VA | FOCUS | OTHER | 540885859 | 01 | VA | VIRGINIA HEALTH NETWORK | OTHER | 540885859 | 01 | VA | COMPMANAGEMENT | OTHER | 540885859 | 01 | VA | PRIVATE HEALTHCARE SYSTEM | OTHER | 008905215 | 05 | VA |   | MEDICAID | 540885859 | 01 | VA | MULTIPLAN | OTHER | 258462 | 01 | VA | SOUTHERN HEALTH | OTHER | 540885859 | 01 | VA | CORVEL | OTHER |