Individual provider Active NPI

Allison Marie Elegbe, P.T.

  • Pediatric Physical Therapist
  • Stafford, VA
National Provider Identifier
1063665362
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
2305203355 Issued in VA
Practice address
2765 Jefferson Davis Hwy Ste 203
Stafford, VA 22554-8331
Phone
(540) 720-2261
NPI assigned
Oct 30, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X 2305203355 VA Primary

Addresses

Primary practice location

2765 Jefferson Davis Hwy Ste 203
Stafford, VA 22554-8331

Mailing address

3013 Leefield Dr
Herndon, VA 20171-1521
Phone (703) 772-6029

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

LicenseStateTypeSpecialty
2305203355VAMDPediatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fleming Therapy Services, LLC Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1225324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1063665362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3013 LEEFIELD DR",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201711521",
            "telephone_number": "703-772-6029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2765 JEFFERSON DAVIS HWY STE 203",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225548331",
            "telephone_number": "540-720-2261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELEGBE",
        "first_name": "ALLISON",
        "middle_name": "MARIE",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-30",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "VA",
            "license": "2305203355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stafford, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.