Individual provider Active NPI

Lorelei Lash

  • Pediatric Physical Therapist
  • Fairfax, VA
National Provider Identifier
1336364801
Registry record updated Mar 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
2305004404 Issued in VA
Practice address
9109 Glenbrook Rd
Fairfax, VA 22031-3008
Phone
(703) 261-9491
Fax
(276) 409-6203
NPI assigned
Apr 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X 2305004404 VA Primary
Physical Therapist 225100000X 2305004404 VA

Addresses

Primary practice location

9109 Glenbrook Rd
Fairfax, VA 22031-3008

Mailing address

9109 Glenbrook Rd
Fairfax, VA 22031-3008

Other identifiers 1

IdentifierTypeStateIssuer
004979907MedicaidVA

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
2305004404VAMDPediatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fierce Friends Therapy, PLLC CurrentSince Mar 12, 2024 Accepting new patients
Skills on the Hill, LLC Physical Therapist PastSince Sep 10, 2023 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709596800000",
    "number": "1336364801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9109 GLENBROOK RD",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220313008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9109 GLENBROOK RD",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220313008",
            "telephone_number": "703-261-9491",
            "fax_number": "276-409-6203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LASH",
        "first_name": "LORELEI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-17",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "VA",
            "license": "2305004404",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305004404",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004979907",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2024; 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.