Individual provider Active NPI

Abigail Jergenson, PT, DPT

  • Physical Therapist
  • Fredericksburg, VA
National Provider Identifier
1609315514
Registry record updated Nov 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305210884 Issued in VA
Practice address
10518 Spotsylvania Ave
Suite 100
Fredericksburg, VA 22408-2693
Phone
(540) 710-5341
Fax
(540) 710-5372
NPI assigned
Feb 13, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2017

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 2305210884 VA Primary

Addresses

Primary practice location

10518 Spotsylvania Ave
Suite 100
Fredericksburg, VA 22408-2693

Mailing address

10518 Spotsylvania Ave
Suite 100
Fredericksburg, VA 22408-2693
Phone (540) 710-5341

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
2305210884VAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1486944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511222400000",
    "number": "1609315514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10518 SPOTSYLVANIA AVE",
            "address_2": "SUITE 100",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224082693",
            "telephone_number": "540-710-5341",
            "fax_number": "540-710-5372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10518 SPOTSYLVANIA AVE",
            "address_2": "SUITE 100",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224082693",
            "telephone_number": "540-710-5341",
            "fax_number": "540-710-5372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JERGENSON",
        "first_name": "ABIGAIL",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-13",
        "last_updated": "2017-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305210884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2017; 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.