Derrilyn Patrice Bagley, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2305216480 Issued in VA

Practice address

450 Garrisonville Rd Ste 101
Stafford, VA 22554-1615

Phone

(540) 242-5216

Fax

(540) 372-3510

NPI assigned

Jul 5, 2024

Last updated

Jul 5, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Central Virginia Orthopaedics & Sports Medicine

  • Orthopaedic Surgery Physician
  • Fredericksburg, VA
  • NPI 1437194289

  Physical Therapist

  Medicare reassignment NPD
• Liberty Sports & Physical Therapy LLC

  • Orthopedic Physical Therapist
  • Fredericksburg, VA
  • NPI 1245980341
  Medicare reassignment NPD

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

{
    "created_epoch": "1720137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720137600000",
    "number": "1194561555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 PARK HILL DR",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224013377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 GARRISONVILLE RD STE 101",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225541615",
            "telephone_number": "540-242-5216",
            "fax_number": "540-372-3510"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 Park Hill Dr",
            "address_purpose": "LOCATION",
            "city": "Fredericksburg",
            "state": "VA",
            "postal_code": "224013377",
            "country_code": "US",
            "telephone_number": "540-372-6745",
            "fax_number": "540-372-3510",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAGLEY",
        "first_name": "DERRILYN",
        "middle_name": "PATRICE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-05",
        "last_updated": "2024-07-05",
        "certification_date": "2024-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305216480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grace Ayres
• Ahmad Shah Aziz I, DO
• Khojistha Azizi, MS, CCC-SLP
• Jordan McKenzie Back, DPT
• Jooyon Bae, RPH
• Iye Bah
• Ousmane Bah
• Munera Ibn Baidoo
• Allyson Rubino Bailey, SLP
• Coley Bailey

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2024; 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.