Active NPI
Carolyn Marie Libert, MSPT
- Physical Therapist
- Fairfax, VA
National Provider Identifier
1013939651
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2305204125
- Practice address
- 8301 Arlington Blvd
Suite 102
Fairfax, VA 22031-2902 - Phone
- (703) 207-8315
- Fax
- (703) 573-2143
- NPI assigned
- Jul 24, 2006
- Sex
- Female
- 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 | 2305204125 | VA | Primary |
Addresses
Primary practice location
8301 Arlington Blvd
Suite 102
Fairfax, VA 22031-2902
Mailing address
8301 Arlington Blvd
Suite 102
Fairfax, VA 22031-2902
Phone (703) 207-8315
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 |
|---|---|---|---|
| 2305204125 | VA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1213747200000",
"number": "1013939651",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8301 ARLINGTON BLVD",
"address_2": "SUITE 102",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220312902",
"telephone_number": "703-207-8315",
"fax_number": "703-573-2143"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8301 ARLINGTON BLVD",
"address_2": "SUITE 102",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220312902",
"telephone_number": "703-207-8315",
"fax_number": "703-573-2143"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIBERT",
"first_name": "CAROLYN",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "MSPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-24",
"last_updated": "2008-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "VA",
"license": "2305204125",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfax, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.