Individual provider Active NPI

Jolene Walsh, PT, MPT

  • Physical Therapist
  • Alexandria, VA
National Provider Identifier
1720141450
Registry record updated Dec 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305206757 Issued in VA
Practice address
2212 Mount Vernon Ave
Core Wellness and Physical Therapy
Alexandria, VA 22301-1356
Phone
(703) 599-0634
NPI assigned
Dec 17, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2305206757 VA Primary
Physical Therapist 225100000X 20693 MD

Addresses

Primary practice location

2212 Mount Vernon Ave
Core Wellness and Physical Therapy
Alexandria, VA 22301-1356

Mailing address

1200 N Quaker LN
Alexandria, VA 22302-3004
Phone (703) 599-0634

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
20693MDMDPharmacist
2305206757VAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1166313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355097600000",
    "number": "1720141450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N QUAKER LN",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223023004",
            "telephone_number": "703-599-0634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2212 MOUNT VERNON AVE",
            "address_2": "CORE WELLNESS AND PHYSICAL THERAPY",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223011356",
            "telephone_number": "703-599-0634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALSH",
        "first_name": "JOLENE",
        "credential": "PT, MPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-17",
        "last_updated": "2012-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305206757",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "20693",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2012; 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.