IndividualActive
Kevin Kisiedu, OT
NPI 1760156038 · Occupational Therapist · Fairfax, VA
Provider details
- NPI number
- 1760156038
- Entity type
- Individual
- Primary specialty
- Occupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- OT
- Sex
- Male
- Sole proprietor
- No
- License
- 0119-009208 (VA)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Profile Score
Established profile(62/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
8501 Arlington Blvd
Fairfax, VA 22031-4617
Phone: (703) 205-1919
Street-level locationGet directions
Mailing address
16740 Flotilla Way
Woodbridge, VA 22191-6301
Registry dates
- Enumerated
- 2021-08-02
- Last updated
- 2021-09-01
- Certified
- 2021-09-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.