Active NPI
Kerrie Jean Golden, DPT
- Physical Therapist
- Dumfries, VA
National Provider Identifier
1396789293
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PTH1579
- Practice address
- 3700 Fettler Park Dr
Dumfries, VA 22025-2050 - Phone
- (703) 441-7658
- NPI assigned
- Jun 15, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PTH1579 | AL | Primary |
Addresses
Primary practice location
3700 Fettler Park Dr
Dumfries, VA 22025-2050
Mailing address
13353 Marie Dr
Manassas, VA 20112-4723
Phone (703) 909-7406
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTH1579 | AL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712275200000",
"number": "1396789293",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13353 MARIE DR",
"city": "MANASSAS",
"state": "VA",
"postal_code": "201124723",
"telephone_number": "703-909-7406"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3700 FETTLER PARK DR",
"city": "DUMFRIES",
"state": "VA",
"postal_code": "220252050",
"telephone_number": "703-441-7658"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDEN",
"first_name": "KERRIE",
"middle_name": "JEAN",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-15",
"last_updated": "2024-04-05",
"certification_date": "2024-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AL",
"license": "PTH1579",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dumfries, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.