Individual provider Active NPI

Virginia Marie Standford, MSPT

  • Physical Therapist
  • Frederick, MD
National Provider Identifier
1104805985
Registry record updated Sep 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
18657 Issued in MD
Practice address
610 Solarex CT
Frederick, MD 21703-8624
Phone
(240) 215-9023
Fax
(240) 215-9026
NPI assigned
Jan 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2010

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 18657 MD Primary

Addresses

Primary practice location

610 Solarex CT
Frederick, MD 21703-8624

Mailing address

9007 Grape Creek Rd
Walkersville, MD 21793-8808
Phone (301) 845-7289

Other identifiers 6

IdentifierTypeStateIssuer
K1340002OtherMDCAP/FED BC
602030700OtherMDDEPT OF LABOR MSS
R5590003OtherMDFSS CAP BC
147719000OtherMDDEPT OF LABOR
546240-06OtherMDCAREFIRST FSS
54624007OtherMDMSS BC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050126000460 MD Practitioner - Physical Therapist in Private Practice 2860442019 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Privia Medical Group, LLCGroup PAC ID 4385682061, 1,522 clinicians

Practice addresses (Care Compare)

11350 Pembrooke SQ
Suite 304
Waldorf, MD 20603-4809
Phone (571) 366-8845

19 W Frederick St
Walkersville, MD 21793-8230
Phone (301) 845-6336

610 Solarex CT
Frederick, MD 21703-8624
Phone (301) 682-5500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18657MDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC CurrentSince Dec 30, 2016 Accepting new patients
Privia Medical Group, LLC CurrentSince Dec 30, 2016 Accepting new patients
Nova Physician Wellness Center PLLC Past Accepting new patients
Frederick Sport & Spine Clinic Past Accepting new patients
Fredericks Sport and Spine Clinic Inc Past Accepting new patients

Locations

133 Defense Hwy
Ste 112
Annapolis, MD 21401
Phone (410) 573-0140

604 Solarex Ct
Unit 104
Frederick, MD 21703
Phone (240) 215-9023

610 Solarex Ct
Frederick, MD 21703
Phone (301) 663-6162

11350 Pembrooke Sq
Ste 304
Waldorf, MD 20603
Phone (301) 856-2810

19 W Frederick St
Walkersville, MD 21793
Phone (301) 662-8541

950 N Glebe Rd
Ste 4000
Arlington, VA 22203
Phone (301) 593-9011

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
  • Direct secure messaging: virginia.standford.1@8042.direct.athenahealth.com

Organizations & group practices 5

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": "1136937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284508800000",
    "number": "1104805985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9007 GRAPE CREEK RD",
            "city": "WALKERSVILLE",
            "state": "MD",
            "postal_code": "217938808",
            "telephone_number": "301-845-7289",
            "fax_number": "240-215-9026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 SOLAREX CT",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217038624",
            "telephone_number": "240-215-9023",
            "fax_number": "240-215-9026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANDFORD",
        "first_name": "VIRGINIA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-11",
        "last_updated": "2010-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "18657",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAP/FED BC",
            "identifier": "K1340002",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR MSS",
            "identifier": "602030700",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FSS CAP BC",
            "identifier": "R5590003",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR",
            "identifier": "147719000",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST FSS",
            "identifier": "546240-06",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MSS BC",
            "identifier": "54624007",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.