Revamp Physical Therapy

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

REVAMP PHYSICAL THERAPY

Practice address

12799 Mill Brook CT
Woodbridge, VA 22192-2922

Phone

(703) 672-0501

NPI assigned

Mar 22, 2024

Last updated

Mar 22, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sonia BorgesNPI 1053725861

Title

Owner

Phone

(540) 333-5102

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sonia Borges, DPT

  • Physical Therapist
  • Burke, VA
  • NPI 1053725861
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1711065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711065600000",
    "number": "1366292427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 792",
            "city": "LORTON",
            "state": "VA",
            "postal_code": "221990792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12799 MILL BROOK CT",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221922922",
            "telephone_number": "703-672-0501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVAMP PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-22",
        "last_updated": "2024-03-22",
        "certification_date": "2024-03-22",
        "status": "A",
        "authorized_official_last_name": "BORGES",
        "authorized_official_first_name": "SONIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "540-333-5102"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Resolution Group Inc
• Resource Anesthesiology Associates of VA, LLC
• Rest Assured Healthcare Services LLC
• Restorative Balance Counseling and Consulting, LLC
• Restorative Health Associates, LLC
• Revamp Support Residential Services LLP
• Revcare DME Solutions LLC
• Kelsey Revelo
• Reverence and Resilience Direct Care Services (Reverenceand Resilience Direct Care Service)
• Revive Aid, LLC

• 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 Mar 22, 2024; 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.