Leesburg Sports, Inc.

Primary specialty

Rehabilitation Clinic/CenterTaxonomy code 261QR0400X

Legal business name

LEESBURG SPORTS, INC.

Doing business as

Physiotherapy Associates

Practice address

19500 Sandridge Way
Suite 390, Riverside Office Park
Lansdowne, VA 20176-3688

Phone

(703) 858-3100

Fax

(703) 858-3101

NPI assigned

Jul 13, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Michael E Tarvin

Title

Vice President & Secretary

Phone

(717) 972-1100

Specialties & licenses 1

Addresses

Other names 1

• Physiotherapy Associates Doing business as

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Leesburg Sports, Inc.

  dba Select Physical Therapy

  • Physical Therapy Clinic/Center
  • Purcellville, VA
  • NPI 1023033354

  O20051107000771

  Same enrollment
• Leesburg Sports, Inc.

  dba Select Physical Therapy

  • Rehabilitation Clinic/Center
  • Leesburg, VA
  • NPI 1245255512

  O20051107000771

  Same enrollment

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540512000000",
    "number": "1174548473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4714 GETTYSBURG RD",
            "address_2": "LEGAL DEPT",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170554325",
            "telephone_number": "717-972-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19500 SANDRIDGE WAY",
            "address_2": "SUITE 390, RIVERSIDE OFFICE PARK",
            "city": "LANSDOWNE",
            "state": "VA",
            "postal_code": "201763688",
            "telephone_number": "703-858-3100",
            "fax_number": "703-858-3101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEESBURG SPORTS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2018-10-26",
        "status": "A",
        "authorized_official_last_name": "TARVIN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "VICE PRESIDENT & SECRETARY",
        "authorized_official_telephone_number": "717-972-1100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Physiotherapy Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Physiotherapy Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lansdowne Pharmacy LLC (Lansdowne Pharmacy)
• Lansdowne Smile Desine
• Lansdowne Travel and Family Medicine LLC
• Lauren Lee, DPT
• Newton Lee, DOM, L.AC.
• Nicole Loren Lefman
• Lighthouse Family Medicine and Wellness PLLC
• Aubrey Elizabeth Ligon, APRN
• Little Pearls Dentistry for Children, PC
• Lmcwellness (Loudoun Medical Care & Wellness)

• Rehabilitation Clinic/Center in Lansdowne, VA
• Providers in Lansdowne, VA by specialty
• Rehabilitation Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2018; 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.