Active NPI
Theresa Dean
- Athletic Trainer
- Fairfax, VA
National Provider Identifier
1215324546
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 3320 Jermantown Rd
Fairfax, VA 22030 - Phone
- (703) 584-2300
- NPI assigned
- Apr 24, 2015
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | Primary |
Addresses
Primary practice location
3320 Jermantown Rd
Fairfax, VA 22030
Mailing address
12237 Fairfield House Dr Apt 307
Fairfax, VA 22033-3953
Phone (571) 241-7218
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1429833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1429833600000",
"number": "1215324546",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12237 FAIRFIELD HOUSE DR APT 307",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220333953",
"telephone_number": "571-241-7218"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3320 JERMANTOWN RD",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "22030",
"telephone_number": "703-584-2300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEAN",
"first_name": "THERESA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-04-24",
"last_updated": "2015-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfax, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.