Omni Wellness & Performance

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

OMNI WELLNESS & PERFORMANCE

Practice address

5589 Guinea Rd
Fairfax, VA 22032-4052

Phone

(703) 989-6014

NPI assigned

Jan 16, 2021

Organization subpart

No

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

Authorized official

Name

Mr. Jose Chacon, PTA

Title

Owner

Phone

(703) 989-6014

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1610755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610755200000",
    "number": "1710576400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5589 GUINEA RD",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220324052",
            "telephone_number": "703-989-6014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5589 GUINEA RD",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220324052",
            "telephone_number": "703-989-6014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMNI WELLNESS & PERFORMANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-16",
        "last_updated": "2021-01-16",
        "certification_date": "2021-01-16",
        "status": "A",
        "authorized_official_last_name": "CHACON",
        "authorized_official_first_name": "JOSE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "703-989-6014",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PTA"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Johanna Elizabeth Olson
• Fola Oluwehinmi, MD
• Danielle Omar, RD
• Suhaila Omar
• Murad M Omery, M.D.
• Omnispine Chiropractic & Rehab Clinic PC
• Ori Onazi
• Elena Marie Ondek
• One Spot Care Provider
• Adam Oneill, PA-C

• Physical Therapy Clinic/Center in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Physical Therapy Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2021; 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.