Aldous Peter Joshua Baroro Odulio, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2305214744 Issued in VA

Practice address

12185 Clipper Dr
Lake Ridge, VA 22192-2236

Phone

(703) 496-3400

NPI assigned

Mar 10, 2022

Last updated

Mar 10, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1646870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646870400000",
    "number": "1245988120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3682 CHIPPENDALE CIR",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221935355",
            "telephone_number": "347-410-0253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12185 CLIPPER DR",
            "city": "LAKE RIDGE",
            "state": "VA",
            "postal_code": "221922236",
            "telephone_number": "703-496-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODULIO",
        "first_name": "ALDOUS PETER JOSHUA",
        "middle_name": "BARORO",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-10",
        "last_updated": "2022-03-10",
        "certification_date": "2022-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "010839",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305214744",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "039677",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mina T Mostofi, DMD
• Kristina R Murphy, PT, MPT
• Megan Riley Murphy, AUD
• Thao Phuong Nguyen, PHARMD
• Ashley Norman, PT, DPT
• Lilly Maire Ortega Torres, EMT
• Ki Soo Park
• Emily C Pastore, AUD
• Patient First Richmond Medical Group (Patient First Lake Ridge)
• Patient First Richmond Medical Group PLLC (Patient First - Lake Ridge)

• Physical Therapist in Lake Ridge, VA
• Providers in Lake Ridge, VA by specialty
• Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2022; 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.