Individual provider Active NPI

Jonathan J Nguyen, PTA

  • Physical Therapy Assistant
  • Arlington, VA
National Provider Identifier
1558645887
Registry record updated Oct 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2306603136 Issued in VA
Practice address
3833 Fairfax Dr
Arlington, VA 22203-1772
Phone
(301) 540-6140
Fax
(301) 540-5190
NPI assigned
Oct 5, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2306603136 VA Primary

Addresses

Primary practice location

3833 Fairfax Dr
Arlington, VA 22203-1772

Mailing address

20410 Century Blvd
NRH Regional Rehab, Suite 215
Germantown, MD 20874-1186
Phone (301) 540-6140

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

LicenseStateTypeSpecialty
2306603136VAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1317772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317772800000",
    "number": "1558645887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20410 CENTURY BLVD",
            "address_2": "NRH REGIONAL REHAB, SUITE 215",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208741186",
            "telephone_number": "301-540-6140",
            "fax_number": "301-540-5190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3833 FAIRFAX DR",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222031772",
            "telephone_number": "301-540-6140",
            "fax_number": "301-540-5190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "JONATHAN",
        "middle_name": "J",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-05",
        "last_updated": "2011-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "VA",
            "license": "2306603136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.