NPIMap

Organization Active NPI

Piedmont Physical Therapy, Inc

  • Physical Therapist
  • Manassas, VA
National Provider Identifier
1194968768
Registry record updated Sep 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305005642 Issued in VA
Legal business name
PIEDMONT PHYSICAL THERAPY, INC
Practice address
8551 Rixlew LN
Suite 340
Manassas, VA 20109-3701
Phone
(703) 368-7343
Fax
(703) 368-0719
NPI assigned
Apr 13, 2009
Last updated
Sep 18, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2013

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

Authorized official

Name
Dr. David E Ebbecke, DPT, MBA, OCSNPI 1811901978
Title
Owner/President
Phone
(703) 368-7343

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 2305005642 VA Primary

Addresses

Primary practice location

8551 Rixlew LN
Suite 340
Manassas, VA 20109-3701

Mailing address

8551 Rixlew LN
Suite 340
Manassas, VA 20109-3701
Phone (703) 368-7343

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090519000342 VA Part B Supplier - Clinic/Group Practice 6709935935 Receives reassigned benefits from 12 practitioners
Practice locations: Gainesville, VA; Manassas, VA

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

7051 Heathcote Village Way
Ste 260
Gainesville, VA 20155
Phone (571) 755-1080

10371 Central Park Dr
Manassas, VA 20110
Phone (703) 393-2632

8551 Rixlew Ln
Ste 340
Manassas, VA 20109
Phone (703) 368-7343

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1239580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379462400000",
    "number": "1194968768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8551 RIXLEW LN",
            "address_2": "SUITE 340",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201093701",
            "telephone_number": "703-368-7343",
            "fax_number": "703-368-0719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8551 RIXLEW LN",
            "address_2": "SUITE 340",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201093701",
            "telephone_number": "703-368-7343",
            "fax_number": "703-368-0719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIEDMONT PHYSICAL THERAPY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-13",
        "last_updated": "2013-09-18",
        "status": "A",
        "authorized_official_last_name": "EBBECKE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "703-368-7343",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT, MBA, OCS"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305005642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manassas, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2013; 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.