Active NPI
Jerri Carr
- Massage Therapist
- Woodbridge, VA
National Provider Identifier
1558728386
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- Practice address
- 14281 Potomac Mills Rd # 103
Woodbridge, VA 22192-6805 - Phone
- (703) 781-0188
- NPI assigned
- Jan 25, 2016
- Last updated
- Sep 24, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 1264001547 | VA | |
| Massage Therapist | 225700000X | NU | Primary | |
| Community Health Worker | 172V00000X | 0019009942 | VA |
Addresses
Primary practice location
14281 Potomac Mills Rd # 103
Woodbridge, VA 22192-6805
Mailing address
5623 Spriggs Meadow Dr
Woodbridge, VA 22193-6217
Phone (703) 781-0188
Other practice location 1
8651 John J Kingman Rd
Fort Belvoir, VA 22060-6200
Phone (703) 781-0188
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0019009942 | VA | MD | Community Health Worker |
| 1264001547 | VA | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Simply Beautiful Skincare and Bodywork,LLC | Current | Accepting new patients |
Locations
14281 Potomac Mills Rd
#103
Woodbridge, VA 22192
Phone (703) 781-0188
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Health Service Clinic/Center
- Woodbridge, VA
- NPI 1326549478
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1453680000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663977600000",
"number": "1558728386",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5623 SPRIGGS MEADOW DR",
"city": "WOODBRIDGE",
"state": "VA",
"postal_code": "221936217",
"telephone_number": "703-781-0188"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14281 POTOMAC MILLS RD # 103",
"city": "WOODBRIDGE",
"state": "VA",
"postal_code": "221926805",
"telephone_number": "703-781-0188"
}
],
"practiceLocations": [
{
"address_1": "8651 John J Kingman Rd",
"address_purpose": "LOCATION",
"city": "Fort Belvoir",
"state": "VA",
"postal_code": "220606200",
"country_code": "US",
"telephone_number": "703-781-0188",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CARR",
"first_name": "JERRI",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-01-25",
"last_updated": "2022-09-24",
"certification_date": "2022-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "VA",
"license": "1264001547",
"primary": false
},
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "NU",
"license": null,
"primary": true
},
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "VA",
"license": "0019009942",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Woodbridge, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.