Active NPI
Kurt Ellis Fedors, PT
- Physical Therapist
- Leesburg, VA
National Provider Identifier
1194224972
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2305211730
- Practice address
- 19500 Sandridge Way Ste 230
Leesburg, VA 20176-3689 - Phone
- (703) 724-7474
- Fax
- (703) 724-9232
- NPI assigned
- Feb 7, 2018
- 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 | 2305211730 | VA | Primary |
Addresses
Primary practice location
19500 Sandridge Way Ste 230
Leesburg, VA 20176-3689
Mailing address
19500 Sandridge Way Ste 230
Leesburg, VA 20176-3689
Phone (703) 724-7474
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2305211730 | VA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Progress Rehabilitation Network, LLC | Physical Therapist | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Physical Therapist
- Glen Allen, VA
- NPI 1801915194
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1517961600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1517961600000",
"number": "1194224972",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19500 SANDRIDGE WAY STE 230",
"city": "LEESBURG",
"state": "VA",
"postal_code": "201763689",
"telephone_number": "703-724-7474",
"fax_number": "703-724-9232"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19500 SANDRIDGE WAY STE 230",
"city": "LEESBURG",
"state": "VA",
"postal_code": "201763689",
"telephone_number": "703-724-7474",
"fax_number": "703-724-9232"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FEDORS",
"first_name": "KURT",
"middle_name": "ELLIS",
"name_prefix": "Dr.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-02-07",
"last_updated": "2018-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "VA",
"license": "2305211730",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Leesburg, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.