Jewels Alyssa Tavera, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2305215610 Issued in VA

Practice address

8550 Lee Hwy Ste 450
Fairfax, VA 22031-1519

Phone

(703) 208-1002

Fax

(703) 208-1127

NPI assigned

Mar 14, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• 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": "1678752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683158400000",
    "number": "1356042634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1610 N AVENUE 55",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900421107",
            "telephone_number": "213-453-3273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8550 LEE HWY STE 450",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220311519",
            "telephone_number": "703-208-1002",
            "fax_number": "703-208-1127"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8140 Ashton Ave Ste 104",
            "address_purpose": "LOCATION",
            "city": "Manassas",
            "state": "VA",
            "postal_code": "201095699",
            "country_code": "US",
            "telephone_number": "703-257-3333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAVERA",
        "first_name": "JEWELS",
        "middle_name": "ALYSSA",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-14",
        "last_updated": "2023-05-04",
        "certification_date": "2023-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "303708",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305215610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Tatlonghari
• Leonardo Tato, MPA-C
• Beverly Hubble Tauke, LCSW
• Monya Tavakoli, DC
• Susan Tavakoli
• Mary Taverner, LCSW
• Sherif S Tawfik, M.D.
• Yaw Tawiah
• Misty Adele Tax, NP-C
• Taylor Nutrition Consulting LLC

• 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 May 4, 2023; 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.