Individual provider Active NPI

Amanda Pauline Daugherty-Ward

  • Physical Therapist
  • Ashburn, VA
National Provider Identifier
1750944799
Registry record updated Apr 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305211979 Issued in VA
Practice address
21785 Filigree CT
Ashburn, VA 20147-6213
Phone
(703) 723-8800
Fax
(703) 723-4134
NPI assigned
Apr 16, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2019

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 26990 MD
Physical Therapist 225100000X 2305211979 VA Primary

Addresses

Primary practice location

21785 Filigree CT
Ashburn, VA 20147-6213

Mailing address

21785 Filigree CT
Ashburn, VA 20147-6213
Phone (703) 723-8800

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
26990MDMDPhysical Therapist
2305211979VAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1555372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555372800000",
    "number": "1750944799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21785 FILIGREE CT",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201476213",
            "telephone_number": "703-723-8800",
            "fax_number": "703-723-4134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21785 FILIGREE CT",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201476213",
            "telephone_number": "703-723-8800",
            "fax_number": "703-723-4134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAUGHERTY-WARD",
        "first_name": "AMANDA",
        "middle_name": "PAULINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-16",
        "last_updated": "2019-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "26990",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305211979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashburn, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2019; 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.