NPIMap

Organization Active NPI

Mid-County Physical Therapy LLC

  • Physical Therapy Clinic/Center
  • Woodbridge, VA
National Provider Identifier
1306070164
Registry record updated Aug 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
2305006481 Issued in VA
Legal business name
MID-COUNTY PHYSICAL THERAPY LLC
Practice address
12581 Milstead Way
Suite 201
Woodbridge, VA 22192
Phone
(703) 763-3922
NPI assigned
May 8, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2010

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

Authorized official

Name
Mr. Charles Sherman Mills III, PTNPI 1831278456
Title
Owner/Physical Therapist
Phone
(703) 763-3922

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 2305006481 VA Primary

Addresses

Primary practice location

12581 Milstead Way
Suite 201
Woodbridge, VA 22192

Mailing address

12581 Milstead Way
Suite 201
Woodbridge, VA 22192
Phone (703) 763-3922

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090610000411 VA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 6709936941 Receives reassigned benefits from 12 practitioners
Practice locations: Woodbridge, VA

National Provider Directory

National Provider Directory

Locations

3421 Commission Ct
Lake Ridge, VA 22192

3421 Commission Ct
Ste 101
Woodbridge, VA 22192
Phone (571) 572-3061

3421 Commission Ct
Ste 100
Woodbridge, VA 22192

12581 Milstead Way
Ste 201
Woodbridge, VA 22192
Phone (703) 763-3922

Practitioners & affiliated clinicians

Practitioners 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1241740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281571200000",
    "number": "1306070164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12581 MILSTEAD WAY",
            "address_2": "SUITE 201",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "22192",
            "telephone_number": "703-763-3922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12581 MILSTEAD WAY",
            "address_2": "SUITE 201",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "22192",
            "telephone_number": "703-763-3922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-COUNTY PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-08",
        "last_updated": "2010-08-12",
        "status": "A",
        "authorized_official_last_name": "MILLS",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "SHERMAN",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "703-763-3922",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "VA",
            "license": "2305006481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.