Physical Restoration and Sports Medicine LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

PHYSICAL RESTORATION AND SPORTS MEDICINE LLC

Practice address

46304 McClellan Way
Sterling, VA 20165-7243

Phone

(703) 444-8210

Fax

(703) 444-8213

NPI assigned

Jan 11, 2010

Last updated

Feb 29, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Marc O Meadows, PT, ATCNPI 1114006384

Title

Owner

Phone

(703) 444-8210

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Locations

Practitioners 1

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.

• Marc Owen Meadows, PT

  • Physical Therapist
  • Sterling, VA
  • NPI 1114006384
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1263168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456704000000",
    "number": "1114257383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46304 MCCLELLAN WAY",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201657243",
            "telephone_number": "703-444-8210",
            "fax_number": "703-444-8213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46304 MCCLELLAN WAY",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201657243",
            "telephone_number": "703-444-8210",
            "fax_number": "703-444-8213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL RESTORATION AND SPORTS MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-11",
        "last_updated": "2016-02-29",
        "status": "A",
        "authorized_official_last_name": "MEADOWS",
        "authorized_official_first_name": "MARC",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "703-444-8210",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT, ATC"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Christian Pfohl Sr., DMD
• Phuong Bich Pham
• Philip I. Koh, DDS, MSD, PC (Sterling Dental Center)
• Kristi M Phillips, NP-C
• Alvin Wei Qi Phua, PSY.D.
• Phystech LLC (Vitality Rehabilitation)
• Valerie Piccolo, PA
• Kirsten L Pierson
• Jasmine Pike, LPC
• Bryan Pittman, D.P.T.

• Physical Therapist in Sterling, VA
• Providers in Sterling, VA by specialty
• Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2016; 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.