Samantha Krejdovsky, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2306605228 Issued in VA

Practice address

8316 Arlington Blvd Ste 520
Fairfax, VA 22031-5216

Phone

(703) 205-1999

NPI assigned

Oct 25, 2018

Last updated

Oct 25, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1540425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540425600000",
    "number": "1710454020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 BROOKSTONE DR",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224052794",
            "telephone_number": "540-735-5121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8316 ARLINGTON BLVD STE 520",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220315216",
            "telephone_number": "703-205-1999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREJDOVSKY",
        "first_name": "SAMANTHA",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-25",
        "last_updated": "2018-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "VA",
            "license": "2306605228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elena Krasteva, RPH
• Daniel Krause, PT
• Meryl Kray, FNP-BC
• Karlin Tate Krebs, CPNP
• Jessica Kreidler, AU.D., CCC-A
• Melchizedek Rod Kresge, DNP, APRN, PMHNP-BC
• Kacia Kriener Putman, LCSW
• Sophie Krishnamoorthy
• Bhanumathi Krishnan, MD
• Alexander H. Krist, MD

• Physical Therapy Assistant in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Physical Therapy Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.