Individual provider Active NPI

Amanda Katherine Engebritson, PT, DPT

  • Physical Therapist
  • Vienna, VA
National Provider Identifier
1073273173
Registry record updated Apr 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305214798 Issued in VA
Practice address
8320 Old Courthouse Rd Ste 410
Vienna, VA 22182-3848
Phone
(703) 734-2889
NPI assigned
Dec 30, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2022

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 2305214798 VA Primary

Addresses

Primary practice location

8320 Old Courthouse Rd Ste 410
Vienna, VA 22182-3848

Mailing address

5704 26TH St N
Arlington, VA 22207-1410
Phone (571) 241-9348

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address aengebritson991228@soc.inova.org Health Information Exchange (HIE) Inova Health Care Services

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
2305214798VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Health Care Services Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: aengebritson991228@soc.inova.org

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": "1640822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650412800000",
    "number": "1073273173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5704 26TH ST N",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222071410",
            "telephone_number": "571-241-9348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8320 OLD COURTHOUSE RD STE 410",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823848",
            "telephone_number": "703-734-2889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENGEBRITSON",
        "first_name": "AMANDA",
        "middle_name": "KATHERINE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-30",
        "last_updated": "2022-04-20",
        "certification_date": "2022-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305214798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aengebritson991228@soc.inova.org",
            "affiliation": "Y",
            "endpointDescription": "Health Information Exchange",
            "affiliationName": "Inova Health Care Services",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "8320 Old Courthouse Rd Ste 410",
            "city": "Vienna",
            "state": "VA",
            "country_code": "US",
            "postal_code": "221823848",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Vienna, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 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.