Individual provider Active NPI

Brian Woogi Kim, DPT

  • Physical Therapist
  • Chantilly, VA
National Provider Identifier
1407284714
Registry record updated May 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305208494 Issued in VA
Practice address
14153 Robert Paris CT Ste a
Chantilly, VA 20151-4225
Phone
(703) 865-6455
Fax
(703) 649-6455
NPI assigned
Oct 23, 2013
Last updated
May 1, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 0121001206 VA
Physical Therapist 225100000X 24747 MD
Physical Therapist 225100000X 2305208494 VA Primary

Addresses

Primary practice location

14153 Robert Paris CT Ste a
Chantilly, VA 20151-4225

Mailing address

14153 Robert Paris CT Ste a
Chantilly, VA 20151-4225
Phone (703) 395-1305

Other identifiers 1

IdentifierTypeStateIssuer
1407284714MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140225000224 DC Practitioner - Physical Therapist in Private Practice 3870723554 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Core Physical Therapy and Rehab., P.C.Group PAC ID 2062702608, 2 clinicians

Practice addresses (Care Compare)

14153 Robert Paris CT
Suite a
Chantilly, VA 20151-4225
Phone (703) 865-6455

14153 Robert Paris CT a
Chantilly, VA 20151-4225

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0121001206VAMDAcupuncturist
24747MDMDPhysical Therapist
2305208494VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Nova Rehab Corp Physical Therapist CurrentSince Jan 9, 2014 Accepting new patients
Core Integrative Care & Wellness, Inc. Acupuncturist CurrentSince May 4, 2025 Accepting new patients
Core Physical Therapy & Rehab., P.C. Acupuncturist CurrentSince Apr 4, 2016 Accepting new patients

Locations

4304 Evergreen Ln
Ste 102
Annandale, VA 22003
Phone (703) 256-7979

14153 Robert Paris Ct
Ste A
Chantilly, VA 20151
Phone (703) 380-7357

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1382486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746057600000",
    "number": "1407284714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14153 ROBERT PARIS CT STE A",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201514225",
            "telephone_number": "703-395-1305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14153 ROBERT PARIS CT STE A",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201514225",
            "telephone_number": "703-865-6455",
            "fax_number": "703-649-6455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "BRIAN",
        "middle_name": "WOOGI",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-10-23",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "VA",
            "license": "0121001206",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "24747",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305208494",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1407284714",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chantilly, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2025; 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.