NPIMap

Organization Active NPI

Cardea Physical Medicine, PLLC

  • Rehabilitation Chiropractor
  • Reston, VA
National Provider Identifier
1598056343
Registry record updated Apr 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
0104556266 Issued in VA
Legal business name
CARDEA PHYSICAL MEDICINE, PLLC
Practice address
12030 N Shore Dr
Reston, VA 20190-4987
Phone
(702) 426-0101
NPI assigned
Apr 27, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2011

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

Authorized official

Name
Dr. Sue H Bedi, D.C.NPI 1700110699
Title
Chiropractor
Phone
(702) 426-0101

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
Rehabilitation ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NR0400X 0104556266 VA Primary

Addresses

Primary practice location

12030 N Shore Dr
Reston, VA 20190-4987

Mailing address

1620 Wenonah Ave
Berwyn, IL 60402-1619
Phone (702) 426-0101

Other names 1

  • Reston Spine and Rehabilition Doing business as

National Provider Directory

National Provider Directory

Locations

1800 Town Center Dr
Ste 315
Reston, VA 20190
Phone (571) 926-8918

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1303862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303862400000",
    "number": "1598056343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 WENONAH AVE",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604021619",
            "telephone_number": "702-426-0101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12030 N SHORE DR",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201904987",
            "telephone_number": "702-426-0101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDEA PHYSICAL MEDICINE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-27",
        "last_updated": "2011-04-27",
        "status": "A",
        "authorized_official_last_name": "BEDI",
        "authorized_official_first_name": "SUE",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "702-426-0101",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": "VA",
            "license": "0104556266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Reston Spine and Rehabilition",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Reston, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 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.