NPIMap

Organization Active NPI

Custom Care Team, Inc.

Doing business as Med Team Therap

  • Rehabilitation Clinic/Center
  • Reston, VA
National Provider Identifier
1285163303
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
CUSTOM CARE TEAM, INC.
Doing business as
Med Team Therap
Med Team Therapy
Practice address
1902 Campus Comons Drive
Suite 650
Reston, VA 20191-1589
Phone
(703) 390-2300
Fax
(703) 390-5819
NPI assigned
Jun 12, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Authorized official

Name
Linda Valentine Harvey, BSN RN
Title
Director of Program and Policy Deve
Phone
(210) 227-9000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X Primary

Addresses

Primary practice location

1902 Campus Comons Drive
Suite 650
Reston, VA 20191-1589

Mailing address

45 NE Loop 410 Ste 800
San Antonio, TX 78216-5837
Phone (210) 227-9000

Other names 2

  • Med Team Therap Doing business as
  • Med Team Therapy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Custom Care Team Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

45 NE Loop 410
Ste 800
San Antonio, TX 78216
Phone (210) 227-9000

NPI Registry JSON

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

{
    "created_epoch": "1497225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1285163303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 NE LOOP 410 STE 800",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782165837",
            "telephone_number": "210-227-9000",
            "fax_number": "210-227-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1902 CAMPUS COMONS DRIVE",
            "address_2": "SUITE 650",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201911589",
            "telephone_number": "703-390-2300",
            "fax_number": "703-390-5819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUSTOM CARE TEAM, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-12",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "HARVEY",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "VALENTINE",
        "authorized_official_title_or_position": "DIRECTOR OF PROGRAM AND POLICY DEVE",
        "authorized_official_telephone_number": "210-227-9000",
        "authorized_official_credential": "BSN RN"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Med Team Therap",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Med Team Therap",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Med Team Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Reston, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.