Amanda N Nguyen, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2305215263 Issued in VA

Practice address

10517 Braddock Rd Ste D
Fairfax, VA 22032-2275

Phone

(571) 351-5618

Fax

(571) 351-5619

NPI assigned

Aug 11, 2022

Sex

Female

Sole proprietor

No

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 DC, VA2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jackson Clinics Limited PartnershipGroup PAC ID 2860623295, 116 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Jackson Clinics Limited Partnership

  • Physical Therapist
  • Centreville, VA
  • NPI 1639594831

  DC

  Medicare reassignment Care Compare group NPD
• The Jackson Clinics LLC

  • Physical Therapist
  • Middleburg, VA
  • NPI 1427034982
  NPD (past)

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

{
    "created_epoch": "1660176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660176000000",
    "number": "1336877877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1769",
            "city": "MIDDLEBURG",
            "state": "VA",
            "postal_code": "201181769",
            "telephone_number": "571-351-5618",
            "fax_number": "571-351-5619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10517 BRADDOCK RD STE D",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220322275",
            "telephone_number": "571-351-5618",
            "fax_number": "571-351-5619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "AMANDA",
        "middle_name": "N",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-11",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305215263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amir Nezam-Shahidi
• Valery Che Ngah
• Wendy-Lucy N Ngassa, DNP
• Duc Minh Ngo, M.D.
• Howard T Ngo, DDS
• Amy Nguyen, DC
• Anh Tram Nguyen, O.D.
• Bao Ngoc Nguyen, D.O.
• Ben L Nguyen, MD
• Bichlan Thi Nguyen, D.D.S.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2022; 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.