Jennifer A Ennis, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2305208403 Issued in VA

Practice address

14524 Potomac Mills Rd
Woodbridge, VA 22192-6803

Phone

(703) 490-6726

Fax

(703) 494-2171

NPI assigned

Nov 11, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA, DC2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Primus Physical TherapyGroup PAC ID 4789981564, 6 clinicians

Practice addresses (Care Compare)

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.

• Primus Physical Therapy

  • Physical Therapist
  • Centreville, VA
  • NPI 1871959726

  DC

  Medicare reassignment Care Compare group NPD
• Primus Physical Therapy Fairfax

  • Physical Therapy Clinic/Center
  • Fairfax, VA
  • NPI 1104461441

  Physical Therapist

  NPD

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

{
    "created_epoch": "1384128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384128000000",
    "number": "1326477308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14524 POTOMAC MILLS RD",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221926803",
            "telephone_number": "703-490-6726",
            "fax_number": "703-494-2171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14524 POTOMAC MILLS RD",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221926803",
            "telephone_number": "703-490-6726",
            "fax_number": "703-494-2171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENNIS",
        "first_name": "JENNIFER",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-11",
        "last_updated": "2013-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305208403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emmanuel Medical Transportation Service
• Emotional Strength Trainers, PLLC
• Empowering Minds 4 Change, LLC
• Empowerpro Services LLC
• Endoscopy & Digestive Center of Woodbridge
• Zipporah Nyoh Enoh, LGSW
• Envoy of Woodbridge, LLC
• Jason B Epstein, PSY.D.
• Erb and Associates
• Mercy Eresechima

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.