Individual provider Active NPI

Timothy Eckert

  • Physical Therapist
  • Washington, DC
National Provider Identifier
1679069876
Registry record updated Jul 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT872222 Issued in DC
Practice address
3508 Connecticut Ave NW
Washington, DC 20008-2401
Phone
(389) 020-2897
NPI assigned
Jul 11, 2018
Last updated
Jul 11, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2018

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 PT872222 DC Primary

Addresses

Primary practice location

3508 Connecticut Ave NW
Washington, DC 20008-2401

Mailing address

350 New Fidelity CT
Garner, NC 27529-2665
Phone (919) 258-2714

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181010000969 DC Practitioner - Physical Therapist in Private Practice 1153673785 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Sportscare & Rehab, LLC Physical Therapist CurrentSince Jul 10, 2018 Accepting new patients

Locations

1001 G St NW
Washington, DC 20001
Phone (202) 347-7745

3508 Connecticut Ave NW
Washington, DC 20008
Phone (202) 897-3890

1600 Wilson Blvd
Ste 102
Arlington, VA 22209
Phone (301) 464-4500

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1531267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531267200000",
    "number": "1679069876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 NEW FIDELITY CT",
            "city": "GARNER",
            "state": "NC",
            "postal_code": "275292665",
            "telephone_number": "919-258-2714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3508 CONNECTICUT AVE NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200082401",
            "telephone_number": "389-020-2897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ECKERT",
        "first_name": "TIMOTHY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-11",
        "last_updated": "2018-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "DC",
            "license": "PT872222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2018; 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.