Courtney E Reynolds, PT, DPT

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

License

2305213018 Issued in VA

Practice address

2239 Tacketts Mill Dr BLDG K
Woodbridge, VA 22192-3026

Phone

(804) 339-2893

NPI assigned

Aug 8, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Pediatric Achievements, LLC

  • Specialist
  • Woodbridge, VA
  • NPI 1720330277
  NPD (past)

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

{
    "created_epoch": "1565222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668729600000",
    "number": "1851946503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5864 LANGTON DR",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223101752",
            "telephone_number": "804-339-2893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2239 TACKETTS MILL DR BLDG K",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221923026",
            "telephone_number": "804-339-2893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "COURTNEY",
        "middle_name": "E",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-08",
        "last_updated": "2022-11-18",
        "certification_date": "2022-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "VA",
            "license": "2305213018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "courtney@pediatricachievements.com",
            "affiliation": "N",
            "address_1": "2239 Tacketts Mill Dr Bldg K",
            "city": "Woodbridge",
            "state": "VA",
            "country_code": "US",
            "postal_code": "221923026",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Revive Aid, LLC
• Lynda Gabriela Reyes
• Madeline Reyes, M.D.
• Sylvia Sierra Reyes
• Erwin Reyna, LCSW
• Masoud Rezvani, M.D.
• Mack B. Rhoades Jr., PHD
• Thuy Rhodes, PHARMD
• Douglas Evan Rhoney, L.P.C.
• Pamela Ri'Chard, DNP, FNP-BC

• Pediatric Physical Therapist in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• Pediatric Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2022; 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.