Active NPI
Justin Frick
- Physical Therapist
- Woodbridge, VA
National Provider Identifier
1053710855
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2305208850
- Practice address
- 14524 Potomac Mills Rd
Woodbridge, VA 22192-6803 - Phone
- (703) 490-6726
- Fax
- (703) 494-2171
- NPI assigned
- Aug 18, 2014
- 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 | 2305208850 | VA | Primary |
Addresses
Primary practice location
14524 Potomac Mills Rd
Woodbridge, VA 22192-6803
Mailing address
13542 Orchard Dr
Clifton, VA 20124-1055
Phone (908) 507-6463
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2305208850 | VA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1408320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1408320000000",
"number": "1053710855",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13542 ORCHARD DR",
"city": "CLIFTON",
"state": "VA",
"postal_code": "201241055",
"telephone_number": "908-507-6463"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14524 POTOMAC MILLS RD",
"city": "WOODBRIDGE",
"state": "VA",
"postal_code": "221926803",
"telephone_number": "703-490-6726",
"fax_number": "703-494-2171"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRICK",
"first_name": "JUSTIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-08-18",
"last_updated": "2014-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "VA",
"license": "2305208850",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodbridge, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.