NPIMap

Organization Active NPI

Primus Physical Therapy Fairfax

  • Physical Therapy Clinic/Center
  • Fairfax, VA
National Provider Identifier
1104461441
Registry record updated Nov 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
PRIMUS PHYSICAL THERAPY FAIRFAX
Practice address
3025 Hamaker CT Ste 103
Fairfax, VA 22031-2221
Phone
(703) 548-4400
Fax
(703) 995-0284
NPI assigned
Nov 11, 2019
Last updated
Nov 11, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2019

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

Authorized official

Name
Kayla Robison, DPTNPI 1588995674
Title
Clinical Services Director
Phone
(703) 548-4400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

3025 Hamaker CT Ste 103
Fairfax, VA 22031-2221

Mailing address

6101 Redwood Square Ctr Ste 202
Centreville, VA 20121-4269
Phone (703) 543-6660

National Provider Directory

National Provider Directory

Locations

6101 Redwood Square Ctr
Ste 202
Centreville, VA 20121
Phone (703) 543-6660

3025 Hamaker Ct
Ste 103
Fairfax, VA 22031
Phone (703) 548-4400

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1573430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573430400000",
    "number": "1104461441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6101 REDWOOD SQUARE CTR STE 202",
            "city": "CENTREVILLE",
            "state": "VA",
            "postal_code": "201214269",
            "telephone_number": "703-543-6660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3025 HAMAKER CT STE 103",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220312221",
            "telephone_number": "703-548-4400",
            "fax_number": "703-995-0284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMUS PHYSICAL THERAPY FAIRFAX",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-11",
        "last_updated": "2019-11-11",
        "status": "A",
        "authorized_official_last_name": "ROBISON",
        "authorized_official_first_name": "KAYLA",
        "authorized_official_title_or_position": "CLINICAL SERVICES DIRECTOR",
        "authorized_official_telephone_number": "703-548-4400",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

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