NPIMap

Organization Active NPI

Alexandria Sports, Inc.

Doing business as Patriot Sportsmedicine

  • Physical Therapy Clinic/Center
  • McLean, VA
National Provider Identifier
1639194152
Registry record updated Feb 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
ALEXANDRIA SPORTS, INC.
Doing business as
Patriot Sportsmedicine
Practice address
8000 Westpark Dr
Suite 150
MC Lean, VA 22102-3114
Phone
(703) 556-8477
Fax
(703) 556-8486
NPI assigned
Jul 13, 2006
Last updated
Feb 25, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2013

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

Authorized official

Name
Mrs. Jayne Fleck Pool
Title
Chief Compliance Officer
Phone
(469) 467-8705

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X NU Primary

Addresses

Primary practice location

8000 Westpark Dr
Suite 150
MC Lean, VA 22102-3114

Mailing address

PO Box 1245
Indiana, PA 15701-5245
Phone (724) 465-3496

Other names 1

  • Patriot Sportsmedicine Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030509000038 VA Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 9931019684 9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Alexandria, VA; Arlington, VA; Burke, VA; Fairfax, VA; Fairfax Station, VA

Other NPIs on the same Medicare enrollment 9

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

8000 Westpark Dr
Ste 150
Mc Lean, VA 22102
Phone (703) 556-8477

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361750400000",
    "number": "1639194152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1245",
            "city": "INDIANA",
            "state": "PA",
            "postal_code": "157015245",
            "telephone_number": "724-465-3496",
            "fax_number": "215-413-4682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8000 WESTPARK DR",
            "address_2": "SUITE 150",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221023114",
            "telephone_number": "703-556-8477",
            "fax_number": "703-556-8486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALEXANDRIA SPORTS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2013-02-25",
        "status": "A",
        "authorized_official_last_name": "POOL",
        "authorized_official_first_name": "JAYNE",
        "authorized_official_middle_name": "FLECK",
        "authorized_official_title_or_position": "CHIEF COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "469-467-8705",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Patriot Sportsmedicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in McLean, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.