Nova Prime Physical Therapy PLLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

NOVA PRIME PHYSICAL THERAPY PLLC

Practice address

13995 Metrotech Dr
Chantilly, VA 20151-3240

Phone

(571) 774-6378

NPI assigned

Dec 26, 2022

Last updated

Jun 1, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Shital Kanaiyalal GandhiNPI 1205389475

Title

Owner

Phone

(727) 317-8896

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Shital Gandhi

  • Physical Therapist
  • Sterling, VA
  • NPI 1205389475

  DC

  Medicare reassignment Care Compare group NPD Authorized official
• Krutika Lakhani, PT

  • Physical Therapist
  • Virginia Beach, VA
  • NPI 1144715277

  DC

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1672012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685577600000",
    "number": "1073226825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 222092",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201532092",
            "telephone_number": "571-774-6378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13995 METROTECH DR",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201513240",
            "telephone_number": "571-774-6378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVA PRIME PHYSICAL THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-26",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A",
        "authorized_official_last_name": "GANDHI",
        "authorized_official_first_name": "SHITAL",
        "authorized_official_middle_name": "KANAIYALAL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "727-317-8896"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nova Birth Services LLC
• Nova Clinical Counseling LLC
• Nova Medical Services,PLLC
• Nova Neuro Brain Center
• Nova Pain & Rehab Center, PLLC
• Nova Senior Home Care Inc. (ComForCare Home Care - Fairfax & Loudoun County)
• Nova Therapy Lounge, LLC
• Katherine E Novak, BA
• Debra O'Beirne, MD
• Dennis P O'Hara, DC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.