Active NPI
Carolina Diaz-Tavera, P.T.
- Physical Therapist
- Alexandria, VA
National Provider Identifier
1639412505
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2305204314
- Practice address
- 2500 N Van Dorn St
Suite 104
Alexandria, VA 22302-1626 - Phone
- (703) 933-1700
- NPI assigned
- Mar 29, 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 | 2305204314 | VA | Primary |
Addresses
Primary practice location
2500 N Van Dorn St
Suite 104
Alexandria, VA 22302-1626
Mailing address
51 Monroe St
Suite 1207
Rockville, MD 20850-2421
Phone (301) 838-2040
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 |
|---|---|---|---|
| 2305204314 | VA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rehab at Work, Corp. | Physical Therapist | Past | Accepting new patients |
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1364515200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1364515200000",
"number": "1639412505",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "51 MONROE ST",
"address_2": "SUITE 1207",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208502421",
"telephone_number": "301-838-2040"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 N VAN DORN ST",
"address_2": "SUITE 104",
"city": "ALEXANDRIA",
"state": "VA",
"postal_code": "223021626",
"telephone_number": "703-933-1700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIAZ-TAVERA",
"first_name": "CAROLINA",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-03-29",
"last_updated": "2013-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "VA",
"license": "2305204314",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Alexandria, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 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.