NPIMap

Individual provider Active NPI

Christine Peterson, DPT

  • Specialist
  • Fairfax, VA
National Provider Identifier
1265682918
Registry record updated Sep 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
2305205680 Issued in VA
Practice address
9860 Fairfax Blvd
Suite 1
Fairfax, VA 22030-1737
Phone
(703) 383-1616
Fax
(703) 383-1166
NPI assigned
Sep 30, 2008
Last updated
Sep 30, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 2305205680 VA Primary

Addresses

Primary practice location

9860 Fairfax Blvd
Suite 1
Fairfax, VA 22030-1737

Mailing address

9860 Fairfax Blvd
Suite 1
Fairfax, VA 22030-1737
Phone (703) 383-1616

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fairfax Orthopaedics, PLLC Specialist PastSince Sep 1, 2002 Accepting new patients
Excel Rehabilitation, PLLC Specialist PastSince Feb 9, 2017 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1222732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222732800000",
    "number": "1265682918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9860 FAIRFAX BLVD",
            "address_2": "SUITE 1",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220301737",
            "telephone_number": "703-383-1616",
            "fax_number": "703-383-1166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9860 FAIRFAX BLVD",
            "address_2": "SUITE 1",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220301737",
            "telephone_number": "703-383-1616",
            "fax_number": "703-383-1166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "CHRISTINE",
        "name_prefix": "Ms.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-30",
        "last_updated": "2008-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "VA",
            "license": "2305205680",
            "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 Sep 30, 2008; 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.