DR. ITORO IBIA M.D. NPI 1356338206

NPI Information

  • NPI: 1356338206
  • Provider Name: DR. ITORO IBIA, M.D.
  • Classification: Psychiatry & Neurology - 2084P0804X
  • Specialization: Child & Adolescent Psychiatry
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 11701 BOWMAN GREEN DR
    RESTON, VA
    ZIP 20190
  • Phone: (703) 707-9777

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NPI Details

DR. Itoro Ibia, M.D. is a child and adolescent psychiatry psychiatry neurology in Reston, VA. The provider is child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. DR. Itoro Ibia, M.D. NPI is 1356338206. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

11701 BOWMAN GREEN DR
RESTON, VA
ZIP 20190-573
Phone: (703) 707-9777
Fax: (703) 707-0690

The NPI 1356338206 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/5/2005 and was last updated on 9/11/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12084P0800XPsychiatry & NeurologyPsychiatry0101223034VIRGINIANo
22084P0804XPsychiatry & NeurologyChild & Adolescent Psychiatry0101223034VIRGINIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1F480-0001OTHERCARE FIRST BCBS ID
22037353OTHERCIGNA ID
3466688OTHERVIRGINIAANTHEM BCBS ID
47267195OTHERAETNA PROVIDER ID

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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