Individual provider Active NPI

Jessie Glennon, DPT

  • Physical Therapist
  • Alexandria, VA
National Provider Identifier
1770257552
Registry record updated May 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305216913 Issued in VA
Practice address
6856 Richmond Hwy
Alexandria, VA 22306-1755
Phone
(571) 302-8633
NPI assigned
Aug 4, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2025

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 PT37511 FL
Physical Therapist 225100000X 2305216913 VA Primary

Addresses

Primary practice location

6856 Richmond Hwy
Alexandria, VA 22306-1755

Mailing address

2122 York Rd Ste 300
Oak Brook, IL 60523-1925
Phone (630) 575-6200

Other practice location 1

2219 County Road 220 Ste 304
Middleburg, FL 32068-7778
Phone (904) 644-7722

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, VA, DC3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20210907000011 FL Practitioner - Physical Therapist in Private Practice 2365848090 Reassigns benefits to 2 organizations
I20250423001233 VA Practitioner - Physical Therapist in Private Practice 2365848090 Reassigns benefits to 1 organization
I20250424000476 DC Practitioner - Physical Therapist in Private Practice 2365848090 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Professional Sportscare and Rehab LLCGroup PAC ID 9335137363, 103 clinicians

Practice addresses (Care Compare)

1600 Wilson Blvd
Suite 102
Arlington, VA 22209-2505
Phone (703) 935-1996

4613 Duke St
Suite B
Alexandria, VA 22304-2559
Phone (703) 751-1052

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT37511FLMDPhysical Therapist
2305216913VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Physical Therapy, PLLC Physical Therapist CurrentSince Aug 9, 2021 Accepting new patients
Oakleaf Family Chiropractic Physical Therapist CurrentSince Jul 12, 2023 Accepting new patients
Professional Sportscare & Rehab, LLC Physical Therapist CurrentSince Apr 17, 2025 Accepting new patients
Professional Sportscare & Rehab, LLC Physical Therapist Past Accepting new patients

Locations

9785 Crosshill Blvd
Ste 108
Jacksonville, FL 32222
Phone (904) 772-6522

2219 County Road 220
Ste 304
Middleburg, FL 32068
Phone (360) 707-8107

2122 York Rd
Ste 300
Oak Brook, IL 60523
Phone (630) 575-6250

4613 Duke St
Ste B
Alexandria, VA 22304
Phone (703) 751-1052

1600 Wilson Blvd
Ste 102
Arlington, VA 22209
Phone (301) 464-4500

11662 Sudley Manor Dr
#50B
Manassas, VA 20109
Phone (571) 321-5720

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1628035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747094400000",
    "number": "1770257552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 YORK RD STE 300",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231925",
            "telephone_number": "630-575-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6856 RICHMOND HWY",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223061755",
            "telephone_number": "571-302-8633"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2219 County Road 220 Ste 304",
            "address_purpose": "LOCATION",
            "city": "Middleburg",
            "state": "FL",
            "postal_code": "320687778",
            "country_code": "US",
            "telephone_number": "904-644-7722",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLENNON",
        "first_name": "JESSIE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-04",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT37511",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305216913",
            "primary": true
        }
    ],
    "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 May 13, 2025; 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.