Organization Active NPI

McLean Physical Therapy & Rehab Services, LLC.

  • Physical Therapist
  • McLean, VA
National Provider Identifier
1275604415
Registry record updated Mar 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4550 Issued in VA
Legal business name
MCLEAN PHYSICAL THERAPY & REHAB SERVICES, LLC.
Practice address
1515 Chain Bridge Rd
Suite #104
McLean, VA 22101-4451
Phone
(703) 356-7801
Fax
(703) 356-7814
NPI assigned
Nov 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2013

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

Authorized official

Name
Anne-Marie Deckx
Title
Physical Therapist
Phone
(703) 356-7801

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 4550 VA Primary

Addresses

Primary practice location

1515 Chain Bridge Rd
Suite #104
McLean, VA 22101-4451

Mailing address

1515 Chain Bridge Rd
Suite #104
McLean, VA 22101-4451
Phone (703) 356-7801

Other identifiers 3

IdentifierTypeStateIssuer
J684OtherVABCBS
3318097OtherVAAETNA HMO
7400481OtherVAAETNA PPO

National Provider Directory

National Provider Directory

Locations

1515 Chain Bridge Rd
Ste 104
McLean, VA 22101
Phone (703) 356-7801

1515 Chain Bridge Rd
#104
McLean, VA 22101
Phone (703) 356-7801

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362700800000",
    "number": "1275604415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 CHAIN BRIDGE RD",
            "address_2": "SUITE #104",
            "city": "MCLEAN",
            "state": "VA",
            "postal_code": "221014451",
            "telephone_number": "703-356-7801",
            "fax_number": "703-356-7814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 CHAIN BRIDGE RD",
            "address_2": "SUITE #104",
            "city": "MCLEAN",
            "state": "VA",
            "postal_code": "221014451",
            "telephone_number": "703-356-7801",
            "fax_number": "703-356-7814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCLEAN PHYSICAL THERAPY & REHAB SERVICES, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-10",
        "last_updated": "2013-03-08",
        "status": "A",
        "authorized_official_last_name": "DECKX",
        "authorized_official_first_name": "ANNE-MARIE",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "703-356-7801"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "4550",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "J684",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "3318097",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "7400481",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McLean, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2013; 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.