Active NPI
Paul Frizelle, DPT
- Physical Therapist
- Centreville, VA
National Provider Identifier
1003189002
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2305207282
- Practice address
- 13890 Braddock Rd
Suite 102
Centreville, VA 20121-2435 - Phone
- (703) 830-6360
- Fax
- (703) 830-6362
- NPI assigned
- Feb 22, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2305207282 | VA | Primary |
Addresses
Primary practice location
13890 Braddock Rd
Suite 102
Centreville, VA 20121-2435
Mailing address
3903 Northdale Blvd
Ste 111W
Tampa, FL 33624-1853
Phone (813) 345-4915
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2305207282 | VA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1329868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1514246400000",
"number": "1003189002",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3903 NORTHDALE BLVD",
"address_2": "STE 111W",
"city": "TAMPA",
"state": "FL",
"postal_code": "336241853",
"telephone_number": "813-345-4915"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13890 BRADDOCK RD",
"address_2": "SUITE 102",
"city": "CENTREVILLE",
"state": "VA",
"postal_code": "201212435",
"telephone_number": "703-830-6360",
"fax_number": "703-830-6362"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRIZELLE",
"first_name": "PAUL",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-02-22",
"last_updated": "2017-12-26",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "VA",
"license": "2305207282",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Centreville, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.