Carly Fuller, PT DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2305215948 Issued in VA

Practice address

1760 Reston Pkwy Ste 403
Reston, VA 20190-3360

Phone

(703) 230-1760

Fax

(702) 230-1761

NPI assigned

Aug 30, 2023

Last updated

Aug 30, 2023By 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 1

Addresses

Other names 1

• Carly McBain Former name

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bodies in Motion Physical Therapy II, LLCGroup PAC ID 9830296367, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bodies in Motion Physical Therapy II, LLC

  • Physical Therapist
  • Reston, VA
  • NPI 1740361641

  DC

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1693353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1063297778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1760 RESTON PKWY STE 403",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201903360",
            "telephone_number": "703-230-1760",
            "fax_number": "702-230-1761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1760 RESTON PKWY STE 403",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201903360",
            "telephone_number": "703-230-1760",
            "fax_number": "702-230-1761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "CARLY",
        "credential": "PT DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-30",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305215948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARLY",
            "last_name": "MCBAIN",
            "credential": "PT DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jennifer Anne Friend, LCSW
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• Jacob Frier, M.ED., BCBA, LBA
• Paula Duncan Fry, RPH
• Jennifer G Fulk, OTR/L
• Jennifer Fuquay Crane
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• Fusion Dental
• Nicholas Gala, PH.D.
• Tanya Galofaro DPT, DPT

• Physical Therapist in Reston, VA
• Providers in Reston, VA by specialty
• Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.