Organization Active NPI

CRC Rehab

  • Physical Medicine & Rehabilitation Physician
  • Leesburg, VA
National Provider Identifier
1104642495
Registry record updated Jun 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
CRC REHAB
Practice address
41516 Bald Hill Rd
Leesburg, VA 20176-6008
Phone
(910) 633-4858
NPI assigned
Dec 2, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2025

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

Authorized official

Name
Joshua K Richter, MDNPI 1144840737
Title
President
Phone
(910) 633-4858

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X Primary

Addresses

Primary practice location

41516 Bald Hill Rd
Leesburg, VA 20176-6008

Mailing address

41516 Bald Hill Rd
Leesburg, VA 20176-6008

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250221001423 VA Part B Supplier - Clinic/Group Practice 2860912722 Receives reassigned benefits from 1 practitioner
Practice locations: Aldie, VA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1733097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750032000000",
    "number": "1104642495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41516 BALD HILL RD",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201766008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41516 BALD HILL RD",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201766008",
            "telephone_number": "910-633-4858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRC REHAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-02",
        "last_updated": "2025-06-16",
        "certification_date": "2025-06-16",
        "status": "A",
        "authorized_official_last_name": "RICHTER",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "910-633-4858",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2025; 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.