Individual provider Active NPI

Ellen Therese Egerton, PT

  • Specialist
  • Leesburg, VA
National Provider Identifier
1780604892
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
2305002834 Issued in VA
Practice address
906 Trailview Blvd SE
Leesburg, VA 20175-4415
Phone
(703) 777-0528
NPI assigned
Jul 20, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

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
Specialist 174400000X 2305002834 VA Primary

Addresses

Primary practice location

906 Trailview Blvd SE
Leesburg, VA 20175-4415

Mailing address

4321 Donna Marie CT
Haymarket, VA 20169-1746
Phone (703) 777-0528

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

State licenses

LicenseStateTypeSpecialty
2305002834VAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
JJS LLC CurrentSince Jul 21, 2024 Accepting new patients

Locations

105 Coastal Ln
Chesapeake, VA 23320
Phone (757) 381-3861

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": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780604892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4321 DONNA MARIE CT",
            "city": "HAYMARKET",
            "state": "VA",
            "postal_code": "201691746",
            "telephone_number": "703-777-0528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "906 TRAILVIEW BLVD SE",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201754415",
            "telephone_number": "703-777-0528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EGERTON",
        "first_name": "ELLEN",
        "middle_name": "THERESE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "VA",
            "license": "2305002834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.