NPIMap

Organization Active NPI

Flagship Rehabilitation, Inc

  • Physical Therapist
  • Lake Ridge, VA
National Provider Identifier
1699259382
Registry record updated Sep 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
FLAGSHIP REHABILITATION, INC
Practice address
12185 Clipper Dr
Lake Ridge, VA 22192-2236
Phone
(703) 496-3486
Fax
(703) 496-3487
NPI assigned
Sep 19, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2018

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

Authorized official

Name
Mrs. Sharon Kathleen Pusey, RN
Title
VP Corporate Compliance/Qi
Phone
(301) 722-3215

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X

Addresses

Primary practice location

12185 Clipper Dr
Lake Ridge, VA 22192-2236

Mailing address

157 Baltimore St Ste 200
Cumberland, MD 21502-2472
Phone (301) 722-3215

Other identifiers 1

IdentifierTypeStateIssuer
0000000004OtherVACOMMERCIAL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181203000313 VA Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 6608777552 Practice locations: Lake Ridge, VA

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Flagship Rehabilitation15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

Ownership & related parties

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Friends Services Alliance (Fsa)Baltimore, MD, CCN 215037 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Apr 15, 2015
Feb 7, 2025
Ingleside at King FarmRockville, MD, CCN 215353 Skilled nursing facility Adp of the SNF Sep 1, 2010
Westminster at Lake RidgeLake Ridge, VA, CCN 495280 Skilled nursing facility Adp of the SNF Jan 1, 2015
Ingleside at Rock CreekWashington, DC, CCN 095028 Skilled nursing facility Adp of the SNF Jan 1, 2015

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1537315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537315200000",
    "number": "1699259382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "157 BALTIMORE ST STE 200",
            "city": "CUMBERLAND",
            "state": "MD",
            "postal_code": "215022472",
            "telephone_number": "301-722-3215",
            "fax_number": "301-722-1028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12185 CLIPPER DR",
            "city": "LAKE RIDGE",
            "state": "VA",
            "postal_code": "221922236",
            "telephone_number": "703-496-3486",
            "fax_number": "703-496-3487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLAGSHIP REHABILITATION, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-19",
        "last_updated": "2018-09-19",
        "status": "A",
        "authorized_official_last_name": "PUSEY",
        "authorized_official_first_name": "SHARON",
        "authorized_official_middle_name": "KATHLEEN",
        "authorized_official_title_or_position": "VP CORPORATE COMPLIANCE/QI",
        "authorized_official_telephone_number": "301-722-3215",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL",
            "identifier": "0000000004",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Ridge, VA

Sources for this page

Verify at the official NPI Registry.