Jacqueline Joanne Corry, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2305206779 Issued in VA

Practice address

8575 Rixlew LN
Manassas, VA 20109-3701

Phone

(703) 257-9770

Fax

(703) 257-2937

NPI assigned

Jul 7, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Familycare Physical Therapy

  • Physical Therapist
  • Clinton, WA
  • NPI 1235173576
  NPD (past)

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310342400000",
    "number": "1124025077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8575 RIXLEW LN",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201093701",
            "telephone_number": "703-257-9770",
            "fax_number": "703-257-2937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8575 RIXLEW LN",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201093701",
            "telephone_number": "703-257-9770",
            "fax_number": "703-257-2937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORRY",
        "first_name": "JACQUELINE",
        "middle_name": "JOANNE",
        "name_prefix": "Ms.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-07",
        "last_updated": "2011-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00009564",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "3777512401",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305206779",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUESHIELD",
            "identifier": "9171CO",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "292104132",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT. LABOR & INDUSTRIES",
            "identifier": "0190045",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8422248",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2011; 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.