Theresa Benton

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

0019018874 Issued in VA

Practice address

8500 Executive Park Ave Ste 300
Fairfax, VA 22031-2228

Phone

(703) 698-7117

NPI assigned

Aug 30, 2022

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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 and National Provider Directory roles.

• Multi Discipline Alternative Care Center, LTD

  • Chiropractor
  • Fairfax, VA
  • NPI 1275729501
  NPD

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

{
    "created_epoch": "1661817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661817600000",
    "number": "1407576689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4518 SAMUELS PINE RD",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201511419",
            "telephone_number": "703-826-1525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8500 EXECUTIVE PARK AVE STE 300",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220312228",
            "telephone_number": "703-698-7117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENTON",
        "first_name": "THERESA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-30",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "VA",
            "license": "0019018874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benson W. Yu M.D. PLLC
• Bryan M Benson
• Katherine Benson
• Latifa Bensouidi
• Casey Raymond Benton, M.D.
• Amin Benyounes, M.D.
• Tyler Berch, CRNA
• Grace Berczel, PHARMD
• Elizabeth Ann Berendt, PSY.D.
• Alyssa Berg, MA, CCC-SLP

• Massage Therapist in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Massage Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2022; 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.