FAIRFAX PHYSICAL THERAPY, INCORPORATED (NPI# 1871716563) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871716563 |
| Entity Type | Organization |
| Organization Name | FAIRFAX PHYSICAL THERAPY, INCORPORATED |
| Practice Address |
10525 West Dr Fairfax VA 22030-4230 |
| Practice Telephone | 7039349411 |
| Practice Fax Number | 7039349497 |
| Mailing Telephone | 7039349411 |
| Mailing Fax Number | 7039349497 |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. KEITH DAVID SCOTT (OWNER) |
| Authorized Official Telephone | 7039349411 |
| Authorized Official Credential | PT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2251X0800X |
Physical Therapist Specialization: Orthopedic |
2305203253 | VA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Y | 2251X0800X |
Physical Therapist Specialization: Orthopedic |
2305002566 | VA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
10525 WEST DR |
| City | FAIRFAX |
| State | VA |
| Zip Code | 22030-4230 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962467480 | Jennifer Marie Passino | Physical Therapist | 10525 West Dr, Fairfax, VA 22030-4230 | 2006-04-18 |
| 1417209115 | Viral Katira | Physical Therapist | 10525 West Dr, Fairfax, VA 22030-4230 | 2012-10-05 |
| 1548536774 | Ashley Camille Boyle | Physical Therapist | 10525 West Dr, Fairfax, VA 22030-4230 | 2012-04-02 |
| 1902968761 | Keith David Scott | Physical Therapist | 10525 West Dr, Fairfax, VA 22030-4230 | 2006-12-15 |
| 1417037367 | Patrice Marie Winter | Physical Therapist | 10525 West Dr, Fairfax, VA 22030-4230 | 2006-10-16 |
| 1073614210 | Marcella Renee Breazile | Physical Therapist | 10525 West Dr, Fairfax, VA 22030-4230 | 2006-09-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205449477 | Perry Camp Jr. | Psychologist | 4403 Dixie Hill Rd, Unit 205, Fairfax, VA 22030 | 2020-08-28 |
| 1952940322 | Brightview Fair Oaks, LLC | Alzheimer Center (Dementia Center) | 12725 Lee Highway, Fairfax, VA 22030 | 2020-01-02 |
| 1245871524 | Tori Sprowl | Behavioral Analyst | 10430 Democracy Lane #102b & 103, Fairfax, VA 22030 | 2019-10-08 |
| 1528612124 | Paul Sarigianis | Student in an Organized Health Care Education/Training Program | 10379b Democracy Lane, Fairfax, VA 22030 | 2019-07-31 |
| 1497221303 | Kahak, Inc. | Day Training, Developmentally Disabled Services | 10560 Main Street Suite Ps100, Fairfax, VA 22030 | 2018-10-17 |
| 1689177073 | Shamoona Sharif | Dentist | 11050 Lee Hwy, Fairfax, VA 22030 | 2018-03-13 |
| 1205339538 | Rachael Lee Greene | Social Worker | 4403 Dixie Hill Rd. #206, Fairfax, VA 22030 | 2018-03-13 |
| 1558863027 | Jacqueline Renee Bauer | Skilled Nursing Facility | 10701 Main Street, Fairfax, VA 22030 | 2018-03-01 |
| 1275033607 | Philajo Global LLC | Non-emergency Medical Transport (VAN) | 4521 Billingham Street, Fairfax, VA 22030 | 2018-02-12 |
| 1376050401 | Alexander Harrison | Counselor | 4400 University Drive, Ms 2a2, Fairfax, VA 22030 | 2018-01-10 |
| Find all providers in zip 22030 | ||||
| Taxonomy Code | 2251X0800X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Orthopedic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508393174 | Orthocare Physical Therapy Center, LLC | Physical Therapist | 13135 Lee Jackson Memorial Hwy Ste 320, Fairfax, VA 22033-1907 | 2017-05-15 |
| 1326137712 | Stephanie James Harris | Physical Therapist | 4211 Fairfax Corner Ave E, Suite 200, Fairfax, VA 22030-8622 | 2006-10-12 |
| 1760404719 | Kevin Linde | Physical Therapist | 3913 Old Lee Hwy, Suite 31c, Fairfax, VA 22030-2433 | 2006-07-25 |
| 1972120061 | Minh Phan | Physical Therapist | 10260 Main St, Fairfax, VA 22030-2404 | 2020-07-06 |
| 1164941845 | Hayley Hammond | Physical Therapist | 9860 Fairfax Blvd Ste 1, Fairfax, VA 22030-1702 | 2017-09-14 |
| 1346781192 | Maria Antonette Aspa | Physical Therapist | 11350 Random Hills Rd, Suite 800, Fairfax, VA 22030-6044 | 2017-03-13 |
| 1376908624 | Set Sports Physical Therapy, LLC | Physical Therapist | 3025 Hamaker Ct Ste 103, Fairfax, VA 22031-2221 | 2015-12-30 |
| 1316313257 | Lauren Simpkins | Physical Therapist | 8501 Arlington Blvd Ste 400, Fairfax, VA 22031-4625 | 2015-08-14 |
| 1548640287 | Gina Decaro | Physical Therapist | 8301 Arlington Blvd, Suite 209, Fairfax, VA 22031-2902 | 2015-06-08 |
| 1245652627 | Lindsey Rolinski | Physical Therapist | 11240 Waples Mill Rd, #202, Fairfax, VA 22030-6078 | 2014-01-20 |
| Find all providers in FAIRFAX | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.