Individual provider Active NPI

Jill Marie McKay, PT

  • Physical Therapist
  • Reston, VA
National Provider Identifier
1780987495
Registry record updated Dec 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305204248 Issued in VA
Practice address
12052 N Shore Dr
Reston, VA 20190-4969
Phone
(703) 834-9800
NPI assigned
Dec 20, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2010

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 0121000375 VA
Physical Therapist 225100000X 2305204248 VA Primary
Physical Therapist 225100000X 22448 CA
Physical Therapist 225100000X 15151 MA

Addresses

Primary practice location

12052 N Shore Dr
Reston, VA 20190-4969

Mailing address

12052 N Shore Dr
Reston, VA 20190-4969
Phone (703) 834-9800

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
0121000375VAMDAcupuncturist
15151MAMDPhysical Therapist
2305204248VAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1292803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292803200000",
    "number": "1780987495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12052 N SHORE DR",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201904969",
            "telephone_number": "703-834-9800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12052 N SHORE DR",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201904969",
            "telephone_number": "703-834-9800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKAY",
        "first_name": "JILL",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-20",
        "last_updated": "2010-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "VA",
            "license": "0121000375",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305204248",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "22448",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "15151",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reston, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2010; 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.