Andrew C Pak, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2305213062 Issued in VA

Practice address

14535 John Marshall Hwy Ste 203
Gainesville, VA 20155-4025

Phone

(703) 753-0261

Fax

(703) 743-2967

NPI assigned

Aug 6, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1565049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565049600000",
    "number": "1841845971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14535 JOHN MARSHALL HWY STE 203",
            "city": "GAINESVILLE",
            "state": "VA",
            "postal_code": "201554025",
            "telephone_number": "703-753-0261",
            "fax_number": "703-743-2967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14535 JOHN MARSHALL HWY STE 203",
            "city": "GAINESVILLE",
            "state": "VA",
            "postal_code": "201554025",
            "telephone_number": "703-753-0261",
            "fax_number": "703-743-2967"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10402 Bristow Center Dr",
            "address_purpose": "LOCATION",
            "city": "Bristow",
            "state": "VA",
            "postal_code": "201362202",
            "country_code": "US",
            "telephone_number": "703-753-0261 x2",
            "fax_number": "703-743-2967",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11084 Marsh Rd",
            "address_purpose": "LOCATION",
            "city": "Bealeton",
            "state": "VA",
            "postal_code": "227129704",
            "country_code": "US",
            "telephone_number": "703-753-0261 x3",
            "fax_number": "703-743-2967",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAK",
        "first_name": "ANDREW",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-08-06",
        "last_updated": "2019-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305213062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Gainesville, VA
• Providers in Gainesville, VA by specialty
• Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2019; 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.