Individual provider Active NPI

Christopher Ray Haren, MSPT

  • Physical Therapist
  • Vienna, VA
National Provider Identifier
1396819017
Registry record updated Apr 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305204315 Issued in VA
Practice address
501 Church St NE
Suite 105
Vienna, VA 22180-4734
Phone
(703) 938-8585
Fax
(703) 938-8602
NPI assigned
Nov 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2019

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 2305204315 VA Primary

Addresses

Primary practice location

501 Church St NE
Suite 105
Vienna, VA 22180-4734

Mailing address

350 New Fidelity CT
Garner, NC 27529-2665
Phone (919) 258-2714

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190604001008 DC Practitioner - Physical Therapist in Private Practice 7113250374 Reassigns benefits to 2 organizations
I20190702003567 MD Practitioner - Physical Therapist in Private Practice 7113250374 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Professional Sportscare and Rehab LLCGroup PAC ID 9335137363, 103 clinicians

Practice addresses (Care Compare)

1600 Wilson Blvd
Suite 102
Arlington, VA 22209-2505
Phone (703) 935-1996

4613 Duke St
Suite B
Alexandria, VA 22304-2559
Phone (703) 751-1052

Merit-based Incentive Payment System (MIPS)

Final score
88.48 of 100Reported as group
Quality
86.04
Promoting interoperability
99
Improvement activities
40
Cost
76.38

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2305204315VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Sportscare & Rehab, LLC Physical Therapist CurrentSince Apr 15, 2019 Accepting new patients

Locations

2987 Plaza Dr
Dunkirk, MD 20754
Phone (443) 964-6348

1600 Wilson Blvd
Ste 102
Arlington, VA 22209
Phone (301) 464-4500

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": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554076800000",
    "number": "1396819017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 NEW FIDELITY CT",
            "city": "GARNER",
            "state": "NC",
            "postal_code": "275292665",
            "telephone_number": "919-258-2714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 CHURCH ST NE",
            "address_2": "SUITE 105",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221804734",
            "telephone_number": "703-938-8585",
            "fax_number": "703-938-8602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAREN",
        "first_name": "CHRISTOPHER",
        "middle_name": "RAY",
        "name_prefix": "Mr.",
        "credential": "MSPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-17",
        "last_updated": "2019-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305204315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vienna, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.