Mac Physical Therapy Group LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

2305306771 Issued in VA

Legal business name

MAC PHYSICAL THERAPY GROUP LLC

Practice address

14 Pidgeon Hill Dr Ste 400
Sterling, VA 20165-6133

Phone

(703) 430-2371

Fax

(703) 430-1968

NPI assigned

Apr 18, 2016

Last updated

Mar 17, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Peter John Macdaniel, DPTNPI 1922302603

Title

Owner

Phone

(540) 424-5537

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Peter John Macdaniel, D.P.T.

  • Physical Therapist
  • Herndon, VA
  • NPI 1922302603
  Medicare reassignment NPD Authorized official
• Natasha Naeem Chand, PT

  • Orthopedic Physical Therapist
  • Purcellville, VA
  • NPI 1306542303
  Medicare reassignment NPD

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

{
    "created_epoch": "1460937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1720432529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 PIDGEON HILL DR STE 400",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201656133",
            "telephone_number": "703-430-2371",
            "fax_number": "703-430-1968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 PIDGEON HILL DR STE 400",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201656133",
            "telephone_number": "703-430-2371",
            "fax_number": "703-430-1968"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22570 Markey Ct",
            "address_2": "#110",
            "address_purpose": "LOCATION",
            "city": "Sterling",
            "state": "VA",
            "postal_code": "201666915",
            "country_code": "US",
            "telephone_number": "540-424-5537",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MAC PHYSICAL THERAPY GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-18",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "MACDANIEL",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "540-424-5537",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "VA",
            "license": "2305306771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Clinic/Center in Sterling, VA
• Providers in Sterling, 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 Mar 17, 2018; 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.