Individual provider Active NPI

Mary P Nalls, PT

  • Physical Therapist
  • Alexandria, VA
National Provider Identifier
1063430650
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
23050003310 Issued in VA
Practice address
5825 Barclay Dr
Alexandria, VA 22315-5730
Phone
(703) 924-2650
Fax
(703) 690-0344
NPI assigned
Jul 18, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 23050003310 VA Primary

Addresses

Primary practice location

5825 Barclay Dr
Alexandria, VA 22315-5730

Mailing address

8523 Oak Pointe Way
Fairfax Station, VA 22039-3340
Phone (703) 690-6972

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120405000081 DC Practitioner - Physical Therapist in Private Practice 5395734818 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Back in Motion Physical Therapy LLCGroup PAC ID 3274522784, 22 clinicians
Physical Therapy Your Way PLLCGroup PAC ID 9537421300, 12 clinicians

Practice addresses (Care Compare)

9447 B Lorton Market St
Suite 250
Lorton, VA 22079-1963
Phone (703) 372-5716

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
23050003310VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Therapy Your Way PLLC CurrentSince Feb 14, 2018 Accepting new patients
Back in Motion Physical Therapy LLC Physical Therapist CurrentSince Feb 24, 2002 Accepting new patients

Locations

5695 King Centre Dr
Ste 102
Alexandria, VA 22315
Phone (571) 312-6966

5825 Barclay Dr
Alexandria, VA 22315
Phone (703) 690-6972

9447B Lorton Market St
#250
Lorton, VA 22079
Phone (703) 372-5716

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063430650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8523 OAK POINTE WAY",
            "city": "FAIRFAX STATION",
            "state": "VA",
            "postal_code": "220393340",
            "telephone_number": "703-690-6972",
            "fax_number": "703-690-0344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5825 BARCLAY DR",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223155730",
            "telephone_number": "703-924-2650",
            "fax_number": "703-690-0344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NALLS",
        "first_name": "MARY",
        "middle_name": "P",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "23050003310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.