Individual provider Active NPI

Chavone Johnson, PT

  • Physical Therapist
  • Fairfax, VA
National Provider Identifier
1851455448
Registry record updated May 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305204873 Issued in VA
Practice address
3903 Fair Ridge Dr Ste 211
Fairfax, VA 22033-2944
Phone
(703) 865-0667
Fax
(703) 865-0668
NPI assigned
Dec 20, 2006
Last updated
May 27, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2026

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 22054 MD
Physical Therapist 225100000X 2305204873 VA Primary

Addresses

Primary practice location

3903 Fair Ridge Dr Ste 211
Fairfax, VA 22033-2944

Mailing address

4170 Rush St
Fairfax
Fairfax, VA 22033-5524
Phone (571) 294-3557

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120509000151 DC Practitioner - Physical Therapist in Private Practice 4688719602 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3903 Fair Ridge Dr
Suite 211
Fairfax, VA 22033-2944
Phone (703) 865-0667

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22054MDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Proactive Physical Therapy and Wellness LLC Physical Therapist CurrentSince May 9, 2011 Accepting new patients
Integrated Healthcare Systems Inc PastSince Jun 22, 2015 Accepting new patients

Locations

3903 Fair Ridge Dr
Ste 211
Fairfax, VA 22033
Phone (571) 294-3557

Organizations & group practices 2

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": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779840000000",
    "number": "1851455448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4170 RUSH ST",
            "address_2": "FAIRFAX",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220335524",
            "telephone_number": "571-294-3557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3903 FAIR RIDGE DR STE 211",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220332944",
            "telephone_number": "703-865-0667",
            "fax_number": "703-865-0668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CHAVONE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-20",
        "last_updated": "2026-05-27",
        "certification_date": "2026-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "22054",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305204873",
            "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 May 27, 2026; 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.