NPIMap

Organization Active NPI

Renee Packer Pediatric Physical Therapy LLC

  • Pediatric Physical Therapist
  • Aldie, VA
National Provider Identifier
1225322134
Registry record updated Jan 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
2305006016 Issued in VA
Legal business name
RENEE PACKER PEDIATRIC PHYSICAL THERAPY LLC
Practice address
25620 Wyndham Point CT
Aldie, VA 20105-3184
Phone
(703) 489-6629
Fax
(703) 935-8710
NPI assigned
Jun 8, 2011
Last updated
Jan 23, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2024

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

Authorized official

Name
Renee L Packer-LoweNPI 1184650020
Title
Owner/Physical Therapist
Phone
(703) 489-6629

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X 2305202955 VA
Pediatric Physical Therapist 2251P0200X 2305006016 VA Primary
Pediatric Occupational Therapist 225XP0200X 0119004001 VA

Addresses

Primary practice location

25620 Wyndham Point CT
Aldie, VA 20105-3184

Mailing address

25620 Wyndham Point CT
Aldie, VA 20105-3184
Phone (703) 489-6629

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1307491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705968000000",
    "number": "1225322134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25620 WYNDHAM POINT CT",
            "city": "ALDIE",
            "state": "VA",
            "postal_code": "201053184",
            "telephone_number": "703-489-6629",
            "fax_number": "703-935-8710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25620 WYNDHAM POINT CT",
            "city": "ALDIE",
            "state": "VA",
            "postal_code": "201053184",
            "telephone_number": "703-489-6629",
            "fax_number": "703-935-8710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEE PACKER PEDIATRIC PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-08",
        "last_updated": "2024-01-23",
        "certification_date": "2021-09-10",
        "status": "A",
        "authorized_official_last_name": "PACKER-LOWE",
        "authorized_official_first_name": "RENEE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "703-489-6629"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "VA",
            "license": "2305202955",
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "VA",
            "license": "2305006016",
            "primary": true
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "VA",
            "license": "0119004001",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aldie, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.