Individual provider Active NPI

Kevin Gregory Vargo

  • Physical Therapist
  • MC Lean, VA
National Provider Identifier
1295218154
Registry record updated Sep 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305212378 Issued in VA
Practice address
6733 Curran St Ste 100
MC Lean, VA 22101-6032
Phone
(703) 448-0259
NPI assigned
Sep 7, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2305212378 VA Primary

Addresses

Primary practice location

6733 Curran St Ste 100
MC Lean, VA 22101-6032

Mailing address

1011 Arlington Blvd Apt 1016
Arlington, VA 22209-2210
Phone (216) 903-9908

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

LicenseStateTypeSpecialty
2305212378VAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1536278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536278400000",
    "number": "1295218154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 ARLINGTON BLVD APT 1016",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222092210",
            "telephone_number": "216-903-9908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6733 CURRAN ST STE 100",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221016032",
            "telephone_number": "703-448-0259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARGO",
        "first_name": "KEVIN",
        "middle_name": "GREGORY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-07",
        "last_updated": "2018-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305212378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in MC Lean, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 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.