Star Rehab LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

STAR REHAB LLC

Practice address

41465 Speckled Alder CT
Aldie, VA 20105-6036

Phone

(267) 275-1219

Fax

(571) 698-4114

NPI assigned

May 9, 2024

Organization subpart

No

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

Authorized official

Name

Mr. Venugopal Divya, PT

Title

Managing Member

Phone

(267) 275-1219

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

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

{
    "created_epoch": "1715212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788307200000",
    "number": "1083462667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41465 SPECKLED ALDER CT",
            "city": "ALDIE",
            "state": "VA",
            "postal_code": "201056036",
            "telephone_number": "267-275-1219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41465 SPECKLED ALDER CT",
            "city": "ALDIE",
            "state": "VA",
            "postal_code": "201056036",
            "telephone_number": "267-275-1219",
            "fax_number": "571-698-4114"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24600 Millstream Dr Ste 435",
            "address_purpose": "LOCATION",
            "city": "Aldie",
            "state": "VA",
            "postal_code": "201053507",
            "country_code": "US",
            "telephone_number": "267-275-1219",
            "fax_number": "571-698-4114",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "900 Utterback Store Rd",
            "address_purpose": "LOCATION",
            "city": "Great Falls",
            "state": "VA",
            "postal_code": "220661535",
            "country_code": "US",
            "telephone_number": "267-275-1219",
            "fax_number": "571-698-4114",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "STAR REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-09",
        "last_updated": "2026-09-02",
        "certification_date": "2026-09-02",
        "status": "A",
        "authorized_official_last_name": "DIVYA",
        "authorized_official_first_name": "VENUGOPAL",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "267-275-1219",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2026; 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.