Frederic Wixson, MSPT, GCS

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

2305005410 Issued in VA

Practice address

417 E Windsor Ave
Alexandria, VA 22301-1227

Phone

(703) 739-8244

NPI assigned

Dec 17, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in DC, VA2 enrollments

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• In-Home Physical Therapy and Wellness LLC

  • Physical Therapist
  • Annandale, VA
  • NPI 1659085371

  DC

  Medicare reassignment NPD
• Comprehensive Therapeutics LTD

  • Physical Therapist
  • North Riverside, IL
  • NPI 1699094102

  DC, Physical Therapy, VA

  Medicare reassignment NPD
• Comprehensive Therapeutics LTD

  • Physical Therapist
  • Lagrange, GA
  • NPI 1881458354

  Physical Therapy

  NPD

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

{
    "created_epoch": "1576540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586131200000",
    "number": "1194363523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 E WINDSOR AVE",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223011227",
            "telephone_number": "703-739-8244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 E WINDSOR AVE",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223011227",
            "telephone_number": "703-739-8244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIXSON",
        "first_name": "FREDERIC",
        "credential": "MSPT, GCS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-12-17",
        "last_updated": "2020-04-06",
        "certification_date": "2020-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "VA",
            "license": "2305005410",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NONE",
            "identifier": "000000",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.connectvirginia.org",
            "affiliation": "N",
            "address_1": "109 Governor St",
            "city": "Richmond",
            "state": "VA",
            "country_code": "US",
            "postal_code": "232193623",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Without Walls Counseling Center
• Without Walls Counseling Center
• Natalia Wittek, M.ED., CF-SLP
• Anne Colby Wittenberg, L.C.S.W.
• Janet Witucki, PT
• Meseret Wodajo
• Brett A Wohler, M.D.
• Juliette Wohlrab, M.D.
• Breanne Wojcik
• Eden Wolde

• Physical Therapy Clinic/Center in Alexandria, VA
• Providers in Alexandria, VA by specialty
• Physical Therapy Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2020; 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.