Active NPI
Maureen Luckett, MPT
- Physical Therapist
- Alexandria, VA
National Provider Identifier
1467586503
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2305202606
- Practice address
- 3709 Shannons Green Way
Alexandria, VA 22309-3659 - Phone
- (703) 780-7100
- NPI assigned
- Mar 14, 2007
- 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 | 2305202606 | VA | Primary |
Addresses
Primary practice location
3709 Shannons Green Way
Alexandria, VA 22309-3659
Mailing address
1400 S Joyce St
#1409
Arlington, VA 22202-1872
Phone (703) 271-9345
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2305202606 | VA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1467586503",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1400 S JOYCE ST",
"address_2": "#1409",
"city": "ARLINGTON",
"state": "VA",
"postal_code": "222021872",
"telephone_number": "703-271-9345"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3709 SHANNONS GREEN WAY",
"city": "ALEXANDRIA",
"state": "VA",
"postal_code": "223093659",
"telephone_number": "703-780-7100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUCKETT",
"first_name": "MAUREEN",
"name_prefix": "Ms.",
"credential": "MPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "VA",
"license": "2305202606",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.