Nicole Leonie Fainsan, MSPT

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

License

2305207613 Issued in VA

Practice address

150 Elden St
Suite 270
Herndon, VA 20170-4861

Phone

(571) 340-1922

NPI assigned

Apr 9, 2008

Last updated

Mar 6, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Ms. Nicole Leonie Fainsan Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1207699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362528000000",
    "number": "1033382148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11011 BECONTREE LAKE DR",
            "address_2": "APT 210",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201904140",
            "telephone_number": "571-340-1922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 ELDEN ST",
            "address_2": "SUITE 270",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201704861",
            "telephone_number": "571-340-1922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAINSAN",
        "first_name": "NICOLE",
        "middle_name": "LEONIE",
        "name_prefix": "Mrs.",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-09",
        "last_updated": "2013-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "9722",
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "VA",
            "license": "2305207613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "FAINSAN",
            "middle_name": "LEONIE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Fairfax Home Health Care, LLC
• Fairfax Radiological Consultants PC

• Pediatric Physical Therapist in Herndon, VA
• Providers in Herndon, VA by specialty
• Pediatric Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.