Individual provider Active NPI

Alissa Jean Wetmore, DPT

  • Physical Therapist
  • Annandale, VA
National Provider Identifier
1093829491
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305204577 Issued in VA
Practice address
3299 Woodburn Rd
Suite 180
Annandale, VA 22003-1275
Phone
(703) 849-8142
Fax
(703) 849-0735
NPI assigned
Aug 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 2305204577 VA Primary

Addresses

Primary practice location

3299 Woodburn Rd
Suite 180
Annandale, VA 22003-1275

Mailing address

100 Luna Park Dr
Apt. #333
Alexandria, VA 22305-3168
Phone (302) 354-0102

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
2305204577VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Valor Physical Therapy Physical Therapist Current Accepting new patients

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": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093829491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 LUNA PARK DR",
            "address_2": "APT. #333",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223053168",
            "telephone_number": "302-354-0102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3299 WOODBURN RD",
            "address_2": "SUITE 180",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220031275",
            "telephone_number": "703-849-8142",
            "fax_number": "703-849-0735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WETMORE",
        "first_name": "ALISSA",
        "middle_name": "JEAN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305204577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annandale, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.