Individual provider Active NPI

Vanessa Marie Hodge, DPT, PT

  • Physical Therapist
  • Fairfax, VA
National Provider Identifier
1780683946
Registry record updated Jan 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305203856 Issued in VA
Practice address
8501 Arlington Blvd Ste 200
Fairfax, VA 22031
Phone
(703) 970-6490
NPI assigned
Jul 20, 2005
Last updated
Jan 5, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2023

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 2305203856 VA Primary

Addresses

Primary practice location

8501 Arlington Blvd Ste 200
Fairfax, VA 22031

Mailing address

PO Box 37174
Baltimore, MD 21297-3174
Phone (571) 423-5699

Other practice location 1

10517D Braddock Rd
Fairfax, VA 22032-2236
Phone (571) 351-5618

Other practice location 2

6355 Walker Ln
Suite 404
Alexandria, VA 22310-3245
Phone (703) 797-6900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20191217001805 VA Practitioner - Physical Therapist in Private Practice 0749614220 Reassigns benefits to 1 organization
I20200107001776 DC Practitioner - Physical Therapist in Private Practice 0749614220 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson Clinics Limited Partnership Physical Therapist CurrentSince Nov 6, 2019 Accepting new patients
The Jackson Clinics LLC Physical Therapist PastSince Nov 6, 2019 Accepting new patients
Inova Health Care Services Past Accepting new patients

Locations

43490 Yukon Dr
Ashburn, VA 20147
Phone (703) 729-7920

10517 Braddock Rd
Ste D
Fairfax, VA 22032
Phone (571) 351-5618

12701 Fair Lakes Cir
Ste 102
Fairfax, VA 22033

8140 Ashton Ave
Ste 104
Manassas, VA 20109
Phone (703) 257-3333

Organizations & group practices 3

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": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672876800000",
    "number": "1780683946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 37174",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212973174",
            "telephone_number": "571-423-5699",
            "fax_number": "571-423-5698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8501 ARLINGTON BLVD STE 200",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "22031",
            "telephone_number": "703-970-6490"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10517D Braddock Rd",
            "address_purpose": "LOCATION",
            "city": "Fairfax",
            "state": "VA",
            "postal_code": "220322236",
            "country_code": "US",
            "telephone_number": "571-351-5618",
            "fax_number": "571-351-5619",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6355 Walker Ln",
            "address_2": "Suite 404",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "VA",
            "postal_code": "223103245",
            "country_code": "US",
            "telephone_number": "703-797-6900",
            "fax_number": "703-797-6905",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HODGE",
        "first_name": "VANESSA",
        "middle_name": "MARIE",
        "credential": "DPT, PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-20",
        "last_updated": "2023-01-05",
        "certification_date": "2023-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305203856",
            "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 Jan 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.