Individual provider Active NPI

Kevin Linde, L.P.T.

  • Orthopedic Physical Therapist
  • Fairfax, VA
National Provider Identifier
1760404719
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
2305006734 Issued in VA
Practice address
3913 Old Lee Hwy
Suite 31C
Fairfax, VA 22030-2433
Phone
(703) 877-2224
Fax
(703) 277-1962
NPI assigned
Jul 25, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 2305006734 VA Primary

Addresses

Primary practice location

3913 Old Lee Hwy
Suite 31C
Fairfax, VA 22030-2433

Mailing address

10114 Ratcliffe Manor Dr
Fairfax, VA 22030-2427
Phone (703) 383-7742

Other identifiers 3

IdentifierTypeStateIssuer
7460488OtherVAAETNA
192764OtherVAANTHEM
J2990001OtherVACARE FIRST

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120405000635 DC Practitioner - Physical Therapist in Private Practice 9931367109 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3913 Old Lee Hwy 31C
Fairfax, VA 22030-2433
Phone (703) 877-2224

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Linde Physical Therapy Inc. Orthopedic CurrentSince Aug 18, 2003 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760404719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10114 RATCLIFFE MANOR DR",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220302427",
            "telephone_number": "703-383-7742",
            "fax_number": "703-277-1962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3913 OLD LEE HWY",
            "address_2": "SUITE 31C",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220302433",
            "telephone_number": "703-877-2224",
            "fax_number": "703-277-1962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINDE",
        "first_name": "KEVIN",
        "name_prefix": "Mr.",
        "credential": "L.P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "VA",
            "license": "2305006734",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7460488",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "192764",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE FIRST",
            "identifier": "J2990001",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.