NPIMap

Organization Active NPI

DMV Sports Medicine Institute

  • Physical Therapy Clinic/Center
  • Woodbridge, VA
National Provider Identifier
1801282652
Registry record updated Apr 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
2305205379 Issued in VA
Legal business name
DMV SPORTS MEDICINE INSTITUTE
Practice address
13576 Minnieville Rd
Woodbridge, VA 22192-4203
Phone
(703) 314-9891
NPI assigned
Apr 8, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2015

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

Authorized official

Name
Keiron Holmes
Title
Owner
Phone
(793) 314-9891

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 2305205379 VA Primary

Addresses

Primary practice location

13576 Minnieville Rd
Woodbridge, VA 22192-4203

Mailing address

15597 Horseshoe LN
Woodbridge, VA 22191-4128
Phone (703) 314-9891

National Provider Directory

National Provider Directory
Tax ID family
College Sports Rehab2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

13576 Minnieville Rd
Woodbridge, VA 22192
Phone (703) 314-9891

NPI Registry JSON

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

{
    "created_epoch": "1428451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428451200000",
    "number": "1801282652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15597 HORSESHOE LN",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221914128",
            "telephone_number": "703-314-9891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13576 MINNIEVILLE RD",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221924203",
            "telephone_number": "703-314-9891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DMV SPORTS MEDICINE INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-08",
        "last_updated": "2015-04-08",
        "status": "A",
        "authorized_official_last_name": "HOLMES",
        "authorized_official_first_name": "KEIRON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "793-314-9891"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "VA",
            "license": "2305205379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2015; 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.