NPIMap

Organization Active NPI

Performance Physical Therapy,LLC

  • Orthopedic Physical Therapist
  • Lorton, VA
National Provider Identifier
1487889135
Registry record updated Jun 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
2305203265 Issued in VA
Legal business name
PERFORMANCE PHYSICAL THERAPY,LLC
Practice address
7700B Gunston PLZ
Lorton, VA 22079-1897
Phone
(703) 339-3767
Fax
(703) 339-3793
NPI assigned
May 26, 2009
Last updated
Jun 12, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2012

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

Authorized official

Name
Jennifer Lorraine Welsh, MSPTNPI 1336144898
Title
Owner
Phone
(703) 339-3767

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 2251X0800X 2305203265 VA Primary

Addresses

Primary practice location

7700B Gunston PLZ
Lorton, VA 22079-1897

Mailing address

PO Box 243
Lorton, VA 22199-0243
Phone (703) 339-3767

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20091208000047 DC Part B Supplier - Clinic/Group Practice 8820137656 Receives reassigned benefits from 9 practitioners
Practice locations: Chantilly, VA; Lorton, VA
O20190107000943 VA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 8820137656 Receives reassigned benefits from 2 practitioners
Practice locations: Woodbridge, VA

National Provider Directory

National Provider Directory

Locations

4229 Lafayette Center Dr
Ste 1250
Chantilly, VA 20151
Phone (703) 263-2020

7700 Gunston Plz
Lorton, VA 22079

7700 Gunston Plz
#B
Lorton, VA 22079

7700B Gunston Plz
Lorton, VA 22079
Phone (703) 263-2020

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1243296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339459200000",
    "number": "1487889135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 243",
            "city": "LORTON",
            "state": "VA",
            "postal_code": "221990243",
            "telephone_number": "703-339-3767",
            "fax_number": "703-339-3793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7700B GUNSTON PLZ",
            "city": "LORTON",
            "state": "VA",
            "postal_code": "220791897",
            "telephone_number": "703-339-3767",
            "fax_number": "703-339-3793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERFORMANCE PHYSICAL THERAPY,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-26",
        "last_updated": "2012-06-12",
        "status": "A",
        "authorized_official_last_name": "WELSH",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "LORRAINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "703-339-3767",
        "authorized_official_credential": "MSPT"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": "VA",
            "license": "2305203265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lorton, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.