Individual provider Active NPI

Oluchi Ike

  • Physical Therapist
  • Alexandria, VA
National Provider Identifier
1801580923
Registry record updated Dec 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
29448 Issued in MD
Practice address
2807 King St
Alexandria, VA 22302-4012
Phone
(703) 215-9110
NPI assigned
Jun 5, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 29448 MD Primary
Physical Therapist 225100000X CP051523T TX

Addresses

Primary practice location

2807 King St
Alexandria, VA 22302-4012

Mailing address

721 Coffren PL
Upper Marlboro, MD 20774-8561
Phone (240) 274-4111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230919001278 DC Practitioner - Physical Therapist in Private Practice 9638533011 Reassigns benefits to 3 organizations
I20250113000814 VA Practitioner - Physical Therapist in Private Practice 9638533011 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jackson Clinics Limited PartnershipGroup PAC ID 2860623295, 116 clinicians

Practice addresses (Care Compare)

30 Catoctin Cir SE
Suite 112
Leesburg, VA 20175-3614
Phone (571) 918-0197

5115 Leesburg Pike
Falls Church, VA 22041-3207
Phone (703) 824-0701

Merit-based Incentive Payment System (MIPS)

Final score
88.48 of 100Reported as group
Quality
86.04
Promoting interoperability
99
Improvement activities
40
Cost
76.38

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CP051523TTXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson Clinics Limited Partnership Physical Therapist CurrentSince Dec 2, 2024 Accepting new patients
Professional Sportscare & Rehab, LLC Physical Therapist CurrentSince Jan 30, 2024 Accepting new patients
Bal Therapy LLC Physical Therapist CurrentSince Jun 25, 2023 Accepting new patients

Locations

1600 Wilson Blvd
Ste 102
Arlington, VA 22209
Phone (301) 464-4500

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

12701 Fair Lakes Cir
Ste 102
Fairfax, VA 22033

5115 Leesburg Pike
Falls Church, VA 22041
Phone (703) 253-0022

30 Catoctin Cir SE
Ste 112
Leesburg, VA 20175
Phone (571) 918-0197

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1685923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764979200000",
    "number": "1801580923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 COFFREN PL",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207748561",
            "telephone_number": "240-274-4111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2807 KING ST",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223024012",
            "telephone_number": "703-215-9110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IKE",
        "first_name": "OLUCHI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-05",
        "last_updated": "2025-12-06",
        "certification_date": "2025-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "29448",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "CP051523T",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.