Kara Brostrom Minnich

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2305210341 Issued in VA

Practice address

9409 Old Burke Lake Rd
Suite K
Burke, VA 22015-3127

Phone

(703) 425-1800

NPI assigned

Jun 28, 2016

Last updated

Jun 28, 2016By the provider in NPPES

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

Enrollment records 1

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Alexandria Sports, Inc.

  dba Select Physical Therapy

  • Rehabilitation Clinic/Center
  • Fairfax Station, VA
  • NPI 1659967768

  DC

  Medicare reassignment NPD

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

{
    "created_epoch": "1467072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467072000000",
    "number": "1386095669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9409 OLD BURKE LAKE RD",
            "address_2": "SUITE K",
            "city": "BURKE",
            "state": "VA",
            "postal_code": "220153127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9409 OLD BURKE LAKE RD",
            "address_2": "SUITE K",
            "city": "BURKE",
            "state": "VA",
            "postal_code": "220153127",
            "telephone_number": "703-425-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINNICH",
        "first_name": "KARA",
        "middle_name": "BROSTROM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-28",
        "last_updated": "2016-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305210341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ribca Bissrat Mersha
• Amber Meyer, PMHNP
• Joel I Miller, D.P.M.
• Jennifer Susan Milton, NMT
• Jessica Minionis
• Minuteman Transportation
• Ashley Mitchell, LPC
• Kristi Lynn Mitchell, LPC
• Ahmed Mohamed, MD
• Ken Lee Moles, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2016; 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.