Individual provider Active NPI

Randy Joseph O'Brien, DPT

  • Physical Therapist
  • Gainesville, VA
National Provider Identifier
1508917410
Registry record updated Jul 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305005659 Issued in VA
Practice address
7521 Virginia Oaks Dr
Suite 240
Gainesville, VA 20155-3831
Phone
(703) 753-7600
Fax
(703) 753-8070
NPI assigned
Jan 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2305005659 VA Primary

Addresses

Primary practice location

7521 Virginia Oaks Dr
Suite 240
Gainesville, VA 20155-3831

Mailing address

5719 Centre Square Dr
Centreville, VA 20120-1916
Phone (703) 818-8804

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20041220000382 DC Practitioner - Physical Therapist in Private Practice 4385601533 Reassigns benefits to 1 organization
I20050421000184 VA Practitioner - Physical Therapist in Private Practice 4385601533 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Results Rehab and Fitness, IncGroup PAC ID 8224095468, 3 clinicians

Practice addresses (Care Compare)

10373 Democracy LN
Suite a
Fairfax, VA 22030-2588
Phone (703) 385-2855

7521 Virginia Oaks Dr
Suite 240
Gainesville, VA 20155-3831
Phone (703) 753-7600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2305005659VAMDPhysical Therapist

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216080000000",
    "number": "1508917410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5719 CENTRE SQUARE DR",
            "city": "CENTREVILLE",
            "state": "VA",
            "postal_code": "201201916",
            "telephone_number": "703-818-8804",
            "fax_number": "703-818-2498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7521 VIRGINIA OAKS DR",
            "address_2": "SUITE 240",
            "city": "GAINESVILLE",
            "state": "VA",
            "postal_code": "201553831",
            "telephone_number": "703-753-7600",
            "fax_number": "703-753-8070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "RANDY",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2008-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305005659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2008; 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.