Active NPI
Nicole Camille Robertson, PT, DPT
- Physical Therapist
- Sterling, VA
National Provider Identifier
1295051738
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1184713
- Practice address
- 21631 Ridgetop Cir Ste 225
Sterling, VA 20166-4289 - Phone
- (571) 207-8850
- NPI assigned
- Apr 8, 2010
- 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 | 1184713 | TX | Primary |
Addresses
Primary practice location
21631 Ridgetop Cir Ste 225
Sterling, VA 20166-4289
Mailing address
11850 Freedom Dr Apt 709
Reston, VA 20190-6053
Phone (210) 687-0341
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184713 | Other | TX | LICENSE |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1184713 | TX | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1270684800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1737417600000",
"number": "1295051738",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11850 FREEDOM DR APT 709",
"city": "RESTON",
"state": "VA",
"postal_code": "201906053",
"telephone_number": "210-687-0341"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21631 RIDGETOP CIR STE 225",
"city": "STERLING",
"state": "VA",
"postal_code": "201664289",
"telephone_number": "571-207-8850"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTSON",
"first_name": "NICOLE",
"middle_name": "CAMILLE",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-04-08",
"last_updated": "2025-01-21",
"certification_date": "2025-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1184713",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "1184713",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sterling, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.