Individual provider Active NPI

Kaitlyn Elisabeth Canterbury, PT, DPT

  • Physical Therapist
  • Arlington, VA
National Provider Identifier
1780348102
Registry record updated Oct 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305212384 Issued in VA
Practice address
1701 N George Mason Dr
Arlington, VA 22205-3610
Phone
(703) 558-5000
NPI assigned
Oct 22, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X 2305212384 VA Primary

Addresses

Primary practice location

1701 N George Mason Dr
Arlington, VA 22205-3610

Mailing address

900 N Randolph St Apt 1909
Arlington, VA 22203-4076

Other practice location 1

8081 Innovation Park Dr
Fairfax, VA 22031-4867
Phone (571) 472-1390

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
2305212384VAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1634860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634860800000",
    "number": "1780348102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 N RANDOLPH ST APT 1909",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222034076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 N GEORGE MASON DR",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222053610",
            "telephone_number": "703-558-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8081 Innovation Park Dr",
            "address_purpose": "LOCATION",
            "city": "Fairfax",
            "state": "VA",
            "postal_code": "220314867",
            "country_code": "US",
            "telephone_number": "571-472-1390",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CANTERBURY",
        "first_name": "KAITLYN",
        "middle_name": "ELISABETH",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-22",
        "last_updated": "2021-10-22",
        "certification_date": "2021-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305212384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2021; 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.