Active NPI
Great Falls Physical Therapy LLC
- Physical Therapist
- Great Falls, VA
National Provider Identifier
1497304976
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Legal business name
- GREAT FALLS PHYSICAL THERAPY LLC
- Practice address
- 766 Walker Rd Ste B
Great Falls, VA 22066-2650 - Phone
- (703) 349-1030
- Fax
- (703) 364-5124
- NPI assigned
- Sep 8, 2019
- Last updated
- Jun 4, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mary Jean Stack, PT
- Title
- Owner
- Phone
- (703) 349-1030
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | NU | Primary |
Addresses
Primary practice location
766 Walker Rd Ste B
Great Falls, VA 22066-2650
Mailing address
766 Walker Rd Ste B
Great Falls, VA 22066-2650
Phone (703) 349-1030
Other practice location 1
10135 Colvin Run Rd Ste 100
Great Falls, VA 22066-1872
Phone (703) 349-1030
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508262734 | Other | NPI |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | www.greatfallspt.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
10135 Colvin Run Rd
Ste 100
Great Falls, VA 22066
Phone (703) 349-1030
766 Walker Rd
Ste B
Great Falls, VA 22066
Phone (703) 349-1030
Practitioners & affiliated clinicians
Practitioners 8
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1567900800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1780531200000",
"number": "1497304976",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "766 WALKER RD STE B",
"city": "GREAT FALLS",
"state": "VA",
"postal_code": "220662650",
"telephone_number": "703-349-1030",
"fax_number": "703-364-5124"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "766 WALKER RD STE B",
"city": "GREAT FALLS",
"state": "VA",
"postal_code": "220662650",
"telephone_number": "703-349-1030",
"fax_number": "703-364-5124"
}
],
"practiceLocations": [
{
"address_1": "10135 Colvin Run Rd Ste 100",
"address_purpose": "LOCATION",
"city": "Great Falls",
"state": "VA",
"postal_code": "220661872",
"country_code": "US",
"telephone_number": "703-349-1030",
"fax_number": "703-364-5124",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "GREAT FALLS PHYSICAL THERAPY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2019-09-08",
"last_updated": "2026-06-04",
"certification_date": "2026-06-04",
"status": "A",
"authorized_official_last_name": "STACK",
"authorized_official_first_name": "MARY JEAN",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "703-349-1030",
"authorized_official_credential": "PT"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1508262734",
"state": null
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "www.greatfallspt.com",
"affiliation": "N",
"address_1": "766 Walker Rd Ste B",
"city": "Great Falls",
"state": "VA",
"country_code": "US",
"postal_code": "220662650",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Great Falls, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2026; 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.