Organization Active NPI

Progressive Physical Therapy, LLC

Doing business as Phoenix Rehabilitation and Health Services, LLC

  • Physical Therapist
  • Herndon, VA
National Provider Identifier
1033714134
Registry record updated Jan 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PROGRESSIVE PHYSICAL THERAPY, LLC
Doing business as
Phoenix Rehabilitation and Health Services, LLC
Practice address
416 Elden St
Herndon, VA 20170-4511
Phone
(443) 917-2951
NPI assigned
Dec 4, 2020
Last updated
Jan 10, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2022

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

Authorized official

Name
Lauren Lau
Title
Director of Credentialing and Payor
Phone
(724) 989-4564

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

416 Elden St
Herndon, VA 20170-4511

Mailing address

PO Box 392573
Pittsburgh, PA 15251-9500

Other names 1

  • Phoenix Rehabilitation and Health Services, LLC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Phoenix Physical Therapy27 organizations share this tax ID, including this one

Other organizations with this tax ID 26

Organizations that report the same tax identification number in the National Provider Directory.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1607040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641772800000",
    "number": "1033714134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 392573",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152519500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 ELDEN ST",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201704511",
            "telephone_number": "443-917-2951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRESSIVE PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-04",
        "last_updated": "2022-01-10",
        "certification_date": "2022-01-10",
        "status": "A",
        "authorized_official_last_name": "LAU",
        "authorized_official_first_name": "LAUREN",
        "authorized_official_title_or_position": "DIRECTOR OF CREDENTIALING AND PAYOR",
        "authorized_official_telephone_number": "724-989-4564"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Phoenix Rehabilitation and Health Services, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Herndon, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2022; 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.