Organization Active NPI

Excel Growth Therapies, LLC

  • Developmentally Disabled Services Day Training Agency
  • Fredericksburg, VA
National Provider Identifier
1073788931
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
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

Updated by the provider on Jun 11, 2019

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)CodeLicenseStatePrimary
Occupational Therapy AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 224Z00000X VA
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X 2305204162 VA
Physical Therapy AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 225200000X 2306000431 VA
Rehabilitation PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 225400000X VA
Dance TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225600000X VA
Assistive Technology Practitioner Rehabilitation CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 225CA2400X
Assistive Technology Supplier Rehabilitation CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 225CA2500X
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Speech/Language/Hearing Specialist/TechnologistGroup: 193200000X MULTI-SPECIALTY GROUP 235500000X VA
Speech-Language AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 2355S0801X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 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

IdentifierTypeStateIssuer
1073788931MedicaidVA

National Provider Directory

National Provider Directory

Locations

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.

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.

Verify at the official NPI Registry.