Individual provider Active NPI

Renee Olson, DPT

  • Physical Therapist
  • Woodbridge, VA
National Provider Identifier
1235712845
Registry record updated Sep 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305215029 Issued in VA
Practice address
14348 Gideon Dr
Woodbridge, VA 22192-4640
Phone
(703) 490-1112
Fax
(703) 878-8732
NPI assigned
May 2, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2305215029 VA Primary

Addresses

Primary practice location

14348 Gideon Dr
Woodbridge, VA 22192-4640

Mailing address

14348 Gideon Dr
Woodbridge, VA 22192-4640
Phone (703) 490-1112

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230314002337 CA Practitioner - Physical Therapist in Private Practice 9436523446 Reassigns benefits to 1 organization
I20240919003196 VA Practitioner - Physical Therapist in Private Practice 9436523446 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.93 of 100Reported as group
Quality
86.7
Promoting interoperability
100
Improvement activities
40
Cost
73.06

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2305215029VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Centers for Advanced Orthopaedics, LLC CurrentSince Aug 1, 2024 Accepting new patients
Centers for Advanced Orthopaedics, LLC CurrentSince Aug 1, 2024 Accepting new patients
Pair & Marotta Physical Therapy, Inc. Physical Therapist CurrentSince Jan 23, 2023 Accepting new patients
Centers for Advanced Orthopaedics LLC Current Accepting new patients
Pair & Marotta Physical Therapy, Inc. CurrentSince Jan 23, 2023 Accepting new patients

Locations

5337 Truxtun Ave
Bakersfield, CA 93309
Phone (661) 324-0122

2603 G St
Bakersfield, CA 93301
Phone (661) 634-9440

14605 Potomac Branch Dr
Ste 300
Woodbridge, VA 22191
Phone (703) 490-1112

14348 Gideon Dr
Woodbridge, VA 22192
Phone (703) 490-1112

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1619913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727308800000",
    "number": "1235712845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14348 GIDEON DR",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221924640",
            "telephone_number": "703-490-1112",
            "fax_number": "703-878-8732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14348 GIDEON DR",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221924640",
            "telephone_number": "703-490-1112",
            "fax_number": "703-878-8732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "RENEE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-02",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305215029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.