Active NPI
Christine Wallace, PT
- Physical Therapist
- Vienna, VA
National Provider Identifier
1255604385
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2305205726
- Practice address
- 8230 Old Courthouse Rd Ste 350
Vienna, VA 22182-3840 - Phone
- (703) 749-0223
- NPI assigned
- Feb 21, 2012
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2305205726 | VA | Primary |
Addresses
Primary practice location
8230 Old Courthouse Rd Ste 350
Vienna, VA 22182-3840
Mailing address
6411 Whippany Way
Burke, VA 22015-3428
Phone (908) 244-4511
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | christine.aptrehab@gmail.com |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2305205726 | VA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1329782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1578441600000",
"number": "1255604385",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6411 WHIPPANY WAY",
"city": "BURKE",
"state": "VA",
"postal_code": "220153428",
"telephone_number": "908-244-4511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8230 OLD COURTHOUSE RD STE 350",
"city": "VIENNA",
"state": "VA",
"postal_code": "221823840",
"telephone_number": "703-749-0223"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALLACE",
"first_name": "CHRISTINE",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-02-21",
"last_updated": "2020-01-08",
"certification_date": "2020-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "VA",
"license": "2305205726",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "christine.aptrehab@gmail.com",
"affiliation": "N",
"address_1": "8230 Old Courthouse Rd Ste 350",
"city": "Vienna",
"state": "VA",
"country_code": "US",
"postal_code": "221823840",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Vienna, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.