Individual provider Active NPI

Paul James Makin

  • Physical Therapist
  • Stafford, VA
National Provider Identifier
1376047902
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305202953 Issued in VA
Practice address
31 Stafford Ave
Stafford, VA 22554-7246
Phone
(703) 658-6500
NPI assigned
Mar 20, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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 2305202953 VA Primary

Addresses

Primary practice location

31 Stafford Ave
Stafford, VA 22554-7246

Mailing address

3619 Eagle Rock CT
Woodbridge, VA 22192-6403
Phone (703) 583-6369

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
2305202953VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Stafford County Public Schools PastSince Sep 13, 2020 Accepting new patients
Stafford County Public Schools Past 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": "1521504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1376047902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3619 EAGLE ROCK CT",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221926403",
            "telephone_number": "703-583-6369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 STAFFORD AVE",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225547246",
            "telephone_number": "703-658-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKIN",
        "first_name": "PAUL",
        "middle_name": "JAMES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-03-20",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305202953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stafford, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.