Active NPI
Brent Conover, DPT
- Physical Therapist
- Reston, VA
National Provider Identifier
1174838510
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2305206536
- Practice address
- 1831 Wiehle Ave
2ND Floor
Reston, VA 20190 - Phone
- (703) 709-1116
- Fax
- (571) 323-6138
- NPI assigned
- Aug 10, 2010
- Last updated
- Aug 10, 2010
- 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 | 2305206536 | VA | Primary |
Addresses
Primary practice location
1831 Wiehle Ave
2ND Floor
Reston, VA 20190
Mailing address
PO Box 630680
Baltimore, MD 21263
Phone (703) 709-1116
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1281398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1281398400000",
"number": "1174838510",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 630680",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "21263",
"telephone_number": "703-709-1116",
"fax_number": "571-323-6138"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1831 WIEHLE AVE",
"address_2": "2ND FLOOR",
"city": "RESTON",
"state": "VA",
"postal_code": "20190",
"telephone_number": "703-709-1116",
"fax_number": "571-323-6138"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONOVER",
"first_name": "BRENT",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-08-10",
"last_updated": "2010-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "VA",
"license": "2305206536",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Reston, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.