Active NPI
Shahrzad Fattahi, PT
- Physical Therapist
- Reston, VA
National Provider Identifier
1609114370
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2305203171
- Practice address
- 1778 Fountain Dr
Reston, VA 20190-3390 - Phone
- (571) 926-9398
- NPI assigned
- Jan 30, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2305203171 | VA | Primary |
Addresses
Primary practice location
1778 Fountain Dr
Reston, VA 20190-3390
Mailing address
1778 Fountain Dr
Reston, VA 20190-3390
Phone (571) 926-9398
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 |
|---|---|---|---|
| 2305203171 | VA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1359504000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1365638400000",
"number": "1609114370",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1778 FOUNTAIN DR",
"city": "RESTON",
"state": "VA",
"postal_code": "201903390",
"telephone_number": "571-926-9398"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1778 FOUNTAIN DR",
"city": "RESTON",
"state": "VA",
"postal_code": "201903390",
"telephone_number": "571-926-9398"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FATTAHI",
"first_name": "SHAHRZAD",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-01-30",
"last_updated": "2013-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "VA",
"license": "2305203171",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.