Individual provider Active NPI

Elizabeth Susan Scudder, PT, DPT, CERT MDT

  • Physical Therapist
  • Ashburn, VA
National Provider Identifier
1366633208
Registry record updated Jun 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305002973 Issued in VA
Practice address
44927 George Washington Blvd
Ste. 210
Ashburn, VA 20147-4295
Phone
(571) 291-9936
NPI assigned
Aug 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2305002973 VA Primary

Addresses

Primary practice location

44927 George Washington Blvd
Ste. 210
Ashburn, VA 20147-4295

Mailing address

44927 George Washington Blvd
Ste. 210
Ashburn, VA 20147-4295
Phone (571) 291-9936

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2010
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

11150 Sunset Hills Rd
Suite 304
Reston, VA 20190-5335

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Restore PT & Wellness Physical Therapist CurrentSince Aug 5, 2013 Accepting new patients
Scudder Physical Therapy, PLLC Current Accepting new patients

Locations

44927 George Washington Blvd
Ashburn, VA 20147
Phone (571) 291-9936

44927 George Washington Blvd
Ste 210
Ashburn, VA 20147
Phone (571) 291-9936

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": "1186358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371168000000",
    "number": "1366633208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44927 GEORGE WASHINGTON BLVD",
            "address_2": "STE. 210",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201474295",
            "telephone_number": "571-291-9936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44927 GEORGE WASHINGTON BLVD",
            "address_2": "STE. 210",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201474295",
            "telephone_number": "571-291-9936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCUDDER",
        "first_name": "ELIZABETH",
        "middle_name": "SUSAN",
        "name_prefix": "Dr.",
        "credential": "PT, DPT, CERT MDT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-06",
        "last_updated": "2013-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305002973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashburn, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.