Individual provider Active NPI

Theodros Woldegebriel, MSPT, DPT

  • Physical Therapist
  • Alexandria, VA
National Provider Identifier
1770569451
Registry record updated Nov 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305203064 Issued in VA
Practice address
8101 Hinson Farm Rd
Suite 312
Alexandria, VA 22306-3403
Phone
(703) 360-6175
Fax
(703) 360-6477
NPI assigned
Dec 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2305203064 VA Primary

Addresses

Primary practice location

8101 Hinson Farm Rd
Suite 312
Alexandria, VA 22306-3403

Mailing address

PO Box 1769
Middleburg, VA 20118-1769
Phone (540) 687-8181

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1134604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194220800000",
    "number": "1770569451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1769",
            "city": "MIDDLEBURG",
            "state": "VA",
            "postal_code": "201181769",
            "telephone_number": "540-687-8181",
            "fax_number": "540-687-8256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8101 HINSON FARM RD",
            "address_2": "SUITE 312",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223063403",
            "telephone_number": "703-360-6175",
            "fax_number": "703-360-6477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLDEGEBRIEL",
        "first_name": "THEODROS",
        "credential": "MSPT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-15",
        "last_updated": "2007-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305203064",
            "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 Nov 5, 2007; 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.