Individual provider Active NPI

Margaux W Craig, MSPT

  • Physical Therapist
  • Alexandria, VA
National Provider Identifier
1396788790
Registry record updated Oct 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT870379 Issued in DC
Practice address
5901 Kingstowne Village Pkwy
Suite 301
Alexandria, VA 22315-5880
Phone
(703) 924-2650
Fax
(703) 924-2653
NPI assigned
Jun 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 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 PT870379 DC Primary

Addresses

Primary practice location

5901 Kingstowne Village Pkwy
Suite 301
Alexandria, VA 22315-5880

Mailing address

5901 Kingstowne Village Pkwy
Suite 301
Alexandria, VA 22315-5880
Phone (703) 924-2650

Other names 1

  • Margaux A Wallace Former name

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sports Therapy and Rehabilitation,Inc Physical Therapist PastSince Mar 2, 2009 Accepting new patients
Sports Therapy and Rehabilitation LLC Physical Therapist PastSince Jan 1, 2022 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": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382400000000",
    "number": "1396788790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5901 KINGSTOWNE VILLAGE PKWY",
            "address_2": "SUITE 301",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223155880",
            "telephone_number": "703-924-2650",
            "fax_number": "703-924-2653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5901 KINGSTOWNE VILLAGE PKWY",
            "address_2": "SUITE 301",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223155880",
            "telephone_number": "703-924-2650",
            "fax_number": "703-924-2653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAIG",
        "first_name": "MARGAUX",
        "middle_name": "W",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-14",
        "last_updated": "2013-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "DC",
            "license": "PT870379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARGAUX",
            "last_name": "WALLACE",
            "middle_name": "A",
            "credential": "MSPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Alexandria, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2013; 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.