Inner Core Wellness LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2305004830 Issued in VA

Legal business name

INNER CORE WELLNESS LLC

Doing business as

Inner Core Wellness

Practice address

2108 Gallows Rd
Suite a
Vienna, VA 22182-3980

Phone

(703) 506-1010

Fax

(703) 763-2333

NPI assigned

Oct 11, 2012

Organization subpart

No

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

Authorized official

Name

Maria Lourdes Sison-Wright, PTNPI 1700902715

Title

Owner/Physical Therapist

Phone

(703) 506-1010

Specialties & licenses 1

Addresses

Other names 1

• Inner Core Wellness Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Maria Lourdes Sison-Wright, PT

  • Physical Therapist
  • Vienna, VA
  • NPI 1700902715
  NPD Authorized official

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

{
    "created_epoch": "1349913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349913600000",
    "number": "1154673366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2108 GALLOWS RD",
            "address_2": "SUITE A",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823980",
            "telephone_number": "703-506-1010",
            "fax_number": "703-763-2333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2108 GALLOWS RD",
            "address_2": "SUITE A",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823980",
            "telephone_number": "703-506-1010",
            "fax_number": "703-763-2333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNER CORE WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-11",
        "last_updated": "2012-10-11",
        "status": "A",
        "authorized_official_last_name": "SISON-WRIGHT",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "LOURDES",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "703-506-1010",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305004830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Inner Core Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2012; 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.