NPIMap

Organization Active NPI

Spine & Sport Physical Therapy, PLLC

  • Orthopedic Physical Therapist
  • Stephens City, VA
National Provider Identifier
1710135546
Registry record updated Sep 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
2305204141 Issued in VA
Legal business name
SPINE & SPORT PHYSICAL THERAPY, PLLC
Practice address
640 Warrior Dr
Suite 115
Stephens City, VA 22655-4076
Phone
(540) 868-9599
NPI assigned
Sep 4, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2008

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

Authorized official

Name
Dr. Kevin David Forrer, PT, DPTNPI 1285610949
Title
Owner, Director, Physical Therapist
Phone
(610) 507-7878

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 2251X0800X 2305204141 VA Primary

Addresses

Primary practice location

640 Warrior Dr
Suite 115
Stephens City, VA 22655-4076

Mailing address

PO Box 1119
Stephens City, VA 22655-1119

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090115000780 VA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 5698838704 Receives reassigned benefits from 5 practitioners
Practice locations: Stephens City, VA

National Provider Directory

National Provider Directory

Locations

640 Warrior Dr
Ste 115
Stephens City, VA 22655
Phone (540) 868-9599

Practitioners & affiliated clinicians

Practitioners 8

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": "1220486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220486400000",
    "number": "1710135546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1119",
            "city": "STEPHENS CITY",
            "state": "VA",
            "postal_code": "226551119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 WARRIOR DR",
            "address_2": "SUITE 115",
            "city": "STEPHENS CITY",
            "state": "VA",
            "postal_code": "226554076",
            "telephone_number": "540-868-9599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPINE & SPORT PHYSICAL THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-04",
        "last_updated": "2008-09-04",
        "status": "A",
        "authorized_official_last_name": "FORRER",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "OWNER, DIRECTOR, PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "610-507-7878",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": "VA",
            "license": "2305204141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stephens City, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2008; 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.