NPIMap

Organization Active NPI

Proflex Physical Thearpy of Maryland, LLC

  • Physical Medicine & Rehabilitation Physician
  • Chantilly, VA
National Provider Identifier
1760387153
Registry record updated Oct 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
PROFLEX PHYSICAL THEARPY OF MARYLAND, LLC
Practice address
4299 Chantilly Shopping Center Dr Ste 104
Chantilly, VA 20151-4025
Phone
(703) 844-0690
Fax
(703) 782-9379
NPI assigned
Oct 14, 2026
Last updated
Oct 14, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2026

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

Authorized official

Name
Ja'Nise A Williams
Title
Credentialing Specialist
Phone
(301) 932-4788

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X Primary

Addresses

Primary practice location

4299 Chantilly Shopping Center Dr Ste 104
Chantilly, VA 20151-4025

Mailing address

PO Box 791217
Baltimore, MD 21279-1217
Phone (301) 932-4786

National Provider Directory

National Provider Directory
Tax ID family
Proflex Physical Thearpy of Maryland LLC8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1791936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791936000000",
    "number": "1760387153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 791217",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212791217",
            "telephone_number": "301-932-4786",
            "fax_number": "301-932-4789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4299 CHANTILLY SHOPPING CENTER DR STE 104",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201514025",
            "telephone_number": "703-844-0690",
            "fax_number": "703-782-9379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFLEX PHYSICAL THEARPY OF MARYLAND, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-10-14",
        "last_updated": "2026-10-14",
        "certification_date": "2026-10-14",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "JA'NISE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "301-932-4788"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chantilly, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2026; 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.