Individual provider Active NPI

Steven Chung

  • Orthopedic Physical Therapist
  • Reston, VA
National Provider Identifier
1477119568
Registry record updated Dec 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
2305212741 Issued in VA
Practice address
11800 Sunrise Valley Dr Ste 100
Reston, VA 20191-5309
Phone
(703) 709-1116
NPI assigned
May 14, 2019
Last updated
Dec 24, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 24, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X VA
Orthopedic Physical Therapist 2251X0800X 2305212741 VA Primary

Addresses

Primary practice location

11800 Sunrise Valley Dr Ste 100
Reston, VA 20191-5309

Mailing address

11800 Sunrise Valley Dr Ste 100
Reston, VA 20191-5309
Phone (703) 709-1116

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190624000499 DC Practitioner - Physical Therapist in Private Practice 1052645116 Reassigns benefits to 1 organization
I20190719000547 VA Practitioner - Physical Therapist in Private Practice 1052645116 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
May accept Medicare assignment
Group practices
Virginia Therapy and Fitness CenterGroup PAC ID 3072680628, 11 clinicians

Practice addresses (Care Compare)

11800 Sunrise Valley Dr
Suite 100
Reston, VA 20191-5309
Phone (703) 709-1116

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2305212741VAMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Jackson Clinics LLC Physical Therapist PastSince May 20, 2019 Accepting new patients

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": "1557792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640304000000",
    "number": "1477119568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11800 SUNRISE VALLEY DR STE 100",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201915309",
            "telephone_number": "703-709-1116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11800 SUNRISE VALLEY DR STE 100",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201915309",
            "telephone_number": "703-709-1116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "STEVEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-14",
        "last_updated": "2021-12-24",
        "certification_date": "2021-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": null,
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "VA",
            "license": "2305212741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reston, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2021; 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.