Leah A. Stull, P.T., D.P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2305209767 Issued in VA

Practice address

46531 Harry Byrd Hwy
Sterling, VA 20164-3555

Phone

(703) 834-5800

NPI assigned

Sep 10, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Leah A. Samuelson Former name

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Loudoun Sports Therapy Center, LLC

  • Physical Therapist
  • Sterling, VA
  • NPI 1003915000
  Medicare reassignment NPD

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

{
    "created_epoch": "1441843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651881600000",
    "number": "1316315161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45544 MALLARD POINT TER",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201656575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46531 HARRY BYRD HWY",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201643555",
            "telephone_number": "703-834-5800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "208 W D L Ingram Blvd",
            "address_purpose": "LOCATION",
            "city": "Cannon AFB",
            "state": "NM",
            "postal_code": "881035103",
            "country_code": "US",
            "telephone_number": "575-784-7772",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "21251 Ridgetop Cir Ste 140",
            "address_purpose": "LOCATION",
            "city": "Sterling",
            "state": "VA",
            "postal_code": "201666645",
            "country_code": "US",
            "telephone_number": "703-450-4300",
            "fax_number": "703-450-5113",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STULL",
        "first_name": "LEAH",
        "middle_name": "A.",
        "credential": "P.T., D.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-10",
        "last_updated": "2022-05-07",
        "certification_date": "2022-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1266639",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NM",
            "license": "4720",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305209767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LEAH",
            "last_name": "SAMUELSON",
            "middle_name": "A.",
            "credential": "P.T., D.P.T.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physical Therapist in Sterling, VA
• Providers in Sterling, VA by specialty
• Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2022; 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.