Individual provider Active NPI

Robert Cowley, PT, DPT, OCS

  • Physical Therapist
  • Woodbridge, VA
National Provider Identifier
1093214850
Registry record updated Oct 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305211753 Issued in VA
Practice address
12731 Marblestone Dr Ste 202
Woodbridge, VA 22192-8334
Phone
(571) 659-2612
Fax
(571) 659-2619
NPI assigned
Feb 7, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 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 2305211753 VA Primary

Addresses

Primary practice location

12731 Marblestone Dr Ste 202
Woodbridge, VA 22192-8334

Mailing address

12544 Dillingham SQ
Woodbridge, VA 22192-5259
Phone (703) 730-6969

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180504000168 DC Practitioner - Physical Therapist in Private Practice 6002170784 Reassigns benefits to 1 organization
I20210507000437 VA Practitioner - Physical Therapist in Private Practice 6002170784 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Sportscare & Rehab, LLC Physical Therapist CurrentSince Feb 12, 2018 Accepting new patients
Lake Ridge Physical Therapy, LLC Physical Therapist PastSince Oct 30, 2022 Accepting new patients
Professional Sportscare & Rehab, LLC Physical Therapist Past Accepting new patients

Locations

4613 Duke St
Ste B
Alexandria, VA 22304
Phone (703) 751-1052

1600 Wilson Blvd
Ste 102
Arlington, VA 22209
Phone (301) 464-4500

11662 Sudley Manor Dr
#50B
Manassas, VA 20109
Phone (571) 321-5720

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1517961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1093214850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12544 DILLINGHAM SQ",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221925259",
            "telephone_number": "703-730-6969",
            "fax_number": "703-730-1169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12731 MARBLESTONE DR STE 202",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221928334",
            "telephone_number": "571-659-2612",
            "fax_number": "571-659-2619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COWLEY",
        "first_name": "ROBERT",
        "credential": "PT, DPT, OCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-07",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305211753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2022; 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.