Active NPI
Benjamin Birley, PT
- Physical Therapist
- Brambleton, VA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2305213983
- Practice address
- 42365 Soave Dr Ste 200
Brambleton, VA 20148-4888 - Phone
- (571) 349-3116
- Fax
- (571) 349-3119
- NPI assigned
- Nov 11, 2020
- Last updated
- Nov 11, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2305213983 | VA | Primary |
Addresses
Primary practice location
42365 Soave Dr Ste 200
Brambleton, VA 20148-4888
Mailing address
PO Box 1769
Middleburg, VA 20118-1769
Phone (571) 349-3116
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA, DC
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
42365 Soave Dr
Suite 200
Brambleton, VA 20148-4888
Phone (571) 349-3116
4238 Wilson Blvd
Suite 2165
Arlington, VA 22203-1823
Phone (571) 290-7644
8550 Route 29
Fairfax, VA 22031-1519
Phone (703) 208-1002
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2305213983 | VA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jackson Clinics Limited Partnership | Physical Therapist | Current | Accepting new patients |
Locations
43490 Yukon Dr
Ashburn, VA 20147
Phone (703) 729-7920
42365 Soave Dr
Ste 200
Brambleton, VA 20148
Phone (571) 349-3116
12701 Fair Lakes Cir
Ste 102
Fairfax, VA 22033
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1605052800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605052800000",
"number": "1124620505",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1769",
"city": "MIDDLEBURG",
"state": "VA",
"postal_code": "201181769",
"telephone_number": "571-349-3116",
"fax_number": "571-349-3119"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "42365 SOAVE DR STE 200",
"city": "BRAMBLETON",
"state": "VA",
"postal_code": "201484888",
"telephone_number": "571-349-3116",
"fax_number": "571-349-3119"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BIRLEY",
"first_name": "BENJAMIN",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-11-11",
"last_updated": "2020-11-11",
"certification_date": "2020-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "VA",
"license": "2305213983",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Brambleton, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2020; 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.