Individual provider Active NPI

Sarayut Phimpha

  • Massage Therapist
  • Fairfax, VA
National Provider Identifier
1780554378
Registry record updated Nov 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
0019020660 Issued in VA
Practice address
9090 Arlington Blvd
Fairfax, VA 22031-2627
Phone
(240) 779-6761
NPI assigned
Nov 8, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225700000X 0019020660 VA Primary

Addresses

Primary practice location

9090 Arlington Blvd
Fairfax, VA 22031-2627

Mailing address

9090 Arlington Blvd
Fairfax, VA 22031-2627
Phone (240) 779-6761

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
0019020660VAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1762560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762560000000",
    "number": "1780554378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9090 ARLINGTON BLVD",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220312627",
            "telephone_number": "240-779-6761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9090 ARLINGTON BLVD",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220312627",
            "telephone_number": "240-779-6761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHIMPHA",
        "first_name": "SARAYUT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-11-08",
        "last_updated": "2025-11-08",
        "certification_date": "2025-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "VA",
            "license": "0019020660",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Nov 8, 2025; 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.