NPIMap

Organization Active NPI

PR Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Stafford, VA
National Provider Identifier
1114184850
Registry record updated May 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
2305205204 Issued in VA
Legal business name
PR PHYSICAL THERAPY, LLC
Practice address
60 Susa Dr
Suite 123
Stafford, VA 22554-9435
Phone
(540) 446-4919
NPI assigned
May 20, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2008

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

Authorized official

Name
Mrs. Jolene Faught, M.P.T.
Title
Owner, Physical Therapist
Phone
(540) 446-4919

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 2305205204 VA Primary

Addresses

Primary practice location

60 Susa Dr
Suite 123
Stafford, VA 22554-9435

Mailing address

60 Susa Dr Ste 123
Stafford, VA 22554-9435
Phone (540) 446-4919

National Provider Directory

National Provider Directory

Locations

60 Susa Dr
Ste 123
Stafford, VA 22554
Phone (540) 446-4919

NPI Registry JSON

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

{
    "created_epoch": "1211241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211241600000",
    "number": "1114184850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 SUSA DR STE 123",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225549435",
            "telephone_number": "540-446-4919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 SUSA DR",
            "address_2": "SUITE 123",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225549435",
            "telephone_number": "540-446-4919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PR PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-20",
        "last_updated": "2008-05-20",
        "status": "A",
        "authorized_official_last_name": "FAUGHT",
        "authorized_official_first_name": "JOLENE",
        "authorized_official_title_or_position": "OWNER, PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "540-446-4919",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.P.T."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "VA",
            "license": "2305205204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stafford, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2008; 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.