Active NPI
Excel Growth Therapies, LLC
- Developmentally Disabled Services Day Training Agency
- Fredericksburg, VA
National Provider Identifier
1073788931
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmentally Disabled Services Day Training Agency
- Legal business name
- EXCEL GROWTH THERAPIES, LLC
- Practice address
- 10105 S Fulton Dr
Fredericksburg, VA 22408-0260 - Phone
- (571) 931-7420
- Fax
- (877) 771-3419
- NPI assigned
- Apr 22, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Deniece Maragrita' Payne
- Title
- Director
- Phone
- (571) 330-8120
Specialties & licenses 15
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | VA | ||
| Physical Therapist | 225100000X | 2305204162 | VA | |
| Physical Therapy Assistant | 225200000X | 2306000431 | VA | |
| Rehabilitation Practitioner | 225400000X | VA | ||
| Dance Therapist | 225600000X | VA | ||
| Assistive Technology Practitioner Rehabilitation Counselor | 225CA2400X | |||
| Assistive Technology Supplier Rehabilitation Counselor | 225CA2500X | |||
| Occupational Therapist | 225X00000X | |||
| Speech/Language/Hearing Specialist/Technologist | 235500000X | VA | ||
| Speech-Language Assistant | 2355S0801X | |||
| Speech-Language Pathologist | 235Z00000X | VA | ||
| Developmentally Disabled Services Day Training Agency | 251C00000X | Primary | ||
| Early Intervention Provider Agency | 252Y00000X | |||
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | |||
| Customized Equipment (DME) | 332BC3200X |
Addresses
Primary practice location
10105 S Fulton Dr
Fredericksburg, VA 22408-0260
Mailing address
10105 S Fulton Dr
Fredericksburg, VA 22408-0260
Phone (571) 931-7420
Other practice location 1
10851 Tidewater Trl
#103
Fredericksburg, VA 22408-2048
Phone (540) 693-6007
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073788931 | Medicaid | VA |
National Provider Directory
National Provider DirectoryLocations
17775 Main St
#104
Dumfries, VA 22026
Phone (571) 330-8120
507 Westwood Office Park
Fredericksburg, VA 22401
Phone (443) 538-4108
Practitioners & affiliated clinicians
Practitioners 7
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Clinical Social Worker
- Fredericksburg, VA
- NPI 1346275765
-
- Speech-Language Pathologist
- Fredericksburg, VA
- NPI 1417243007
-
- Occupational Therapist
- Fredericksburg, VA
- NPI 1558837641
-
- Speech-Language Pathologist
- Fairfax, VA
- NPI 1043624646
-
- Occupational Therapy Assistant
- Fredericksburg, VA
- NPI 1649401001
-
- School Psychologist
- Fredericksburg, VA
- NPI 1962701730
-
- Music Therapist
- Baltimore, MD
- NPI 1881088458
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1208822400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1560211200000",
"number": "1073788931",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10105 S FULTON DR",
"city": "FREDERICKSBURG",
"state": "VA",
"postal_code": "224080260",
"telephone_number": "571-931-7420",
"fax_number": "877-771-3419"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10105 S FULTON DR",
"city": "FREDERICKSBURG",
"state": "VA",
"postal_code": "224080260",
"telephone_number": "571-931-7420",
"fax_number": "877-771-3419"
}
],
"practiceLocations": [
{
"address_1": "10851 Tidewater Trl",
"address_2": "#103",
"address_purpose": "LOCATION",
"city": "Fredericksburg",
"state": "VA",
"postal_code": "224082048",
"country_code": "US",
"telephone_number": "540-693-6007",
"fax_number": "877-771-3419",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "EXCEL GROWTH THERAPIES, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2008-04-22",
"last_updated": "2019-06-11",
"status": "A",
"authorized_official_last_name": "PAYNE",
"authorized_official_first_name": "DENIECE",
"authorized_official_middle_name": "MARAGRITA'",
"authorized_official_title_or_position": "DIRECTOR",
"authorized_official_telephone_number": "571-330-8120"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Occupational Therapy Assistant",
"state": "VA",
"license": null,
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": "VA",
"license": "2305204162",
"primary": false
},
{
"code": "225200000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Therapy Assistant",
"state": "VA",
"license": "2306000431",
"primary": false
},
{
"code": "225400000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Rehabilitation Practitioner",
"state": "VA",
"license": null,
"primary": false
},
{
"code": "225600000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dance Therapist",
"state": "VA",
"license": null,
"primary": false
},
{
"code": "225CA2400X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Rehabilitation Counselor, Assistive Technology Practitioner",
"state": null,
"license": null,
"primary": false
},
{
"code": "225CA2500X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Rehabilitation Counselor, Assistive Technology Supplier",
"state": null,
"license": null,
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Occupational Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "235500000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Specialist/Technologist",
"state": "VA",
"license": null,
"primary": false
},
{
"code": "2355S0801X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Specialist/Technologist, Speech-Language Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Speech-Language Pathologist",
"state": "VA",
"license": null,
"primary": false
},
{
"code": "251C00000X",
"taxonomy_group": "",
"desc": "Day Training, Developmentally Disabled Services",
"state": null,
"license": null,
"primary": true
},
{
"code": "252Y00000X",
"taxonomy_group": "",
"desc": "Early Intervention Provider Agency",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QM0801X",
"taxonomy_group": "",
"desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
"state": null,
"license": null,
"primary": false
},
{
"code": "332BC3200X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1073788931",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fredericksburg, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.