Individual provider Active NPI

Fatmata M Bangura, DPT

  • Physical Therapist
  • Alexandria, VA
National Provider Identifier
1861029258
Registry record updated Dec 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
CP010037T Issued in VA
Practice address
6856 Richmond Hwy
Alexandria, VA 22306
Phone
(571) 348-1201
Fax
(571) 302-8633
NPI assigned
Mar 25, 2020
Last updated
Dec 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2024

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 27879 MD
Physical Therapist 225100000X CP010037T VA Primary

Addresses

Primary practice location

6856 Richmond Hwy
Alexandria, VA 22306

Mailing address

2122 York Rd Ste 300
Oak Brook, IL 60523-1925
Phone (630) 575-6200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC, VA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20201015001216 MD Practitioner - Physical Therapist in Private Practice 6709206642 Reassigns benefits to 1 organization
I20201015001380 DC Practitioner - Physical Therapist in Private Practice 6709206642 Reassigns benefits to 3 organizations
I20240611003773 VA Practitioner - Physical Therapist in Private Practice 6709206642 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Professional Sportscare and Rehab LLCGroup PAC ID 9335137363, 103 clinicians
Virginia Luna Care Physical Therapy LLCGroup PAC ID 0941615405, 89 clinicians

Practice addresses (Care Compare)

1600 Wilson Blvd
Suite 102
Arlington, VA 22209-2505
Phone (703) 935-1996

3712 Linda LN
Annandale, VA 22003-1510
Phone (866) 525-3175

5109 Arrowbrook CT
Glen Allen, VA 23060-2876
Phone (866) 525-3175

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
27879MDMDClinical Social Worker
CP010037TVAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Sportscare & Rehab, LLC Physical Therapist CurrentSince Oct 12, 2020 Accepting new patients
Virginia Luna Care Physical Therapy LLC Physical Therapist CurrentSince May 28, 2024 Accepting new patients

Locations

2122 York Rd
Ste 300
Oak Brook, IL 60523
Phone (630) 575-6250

2987 Plaza Dr
Dunkirk, MD 20754
Phone (443) 964-6348

2875 Crain Hwy
Ste 6
Waldorf, MD 20601
Phone (301) 859-3304

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

8280 Willow Oaks Corporate Dr
Ste 600
Fairfax, VA 22031
Phone (202) 794-7159

4870 Sadler Rd
Ste 300
Glen Allen, VA 23060
Phone (757) 524-2304

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, 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": "1585094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1861029258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 YORK RD STE 300",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231925",
            "telephone_number": "630-575-6200",
            "fax_number": "410-648-4878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6856 RICHMOND HWY",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "22306",
            "telephone_number": "571-348-1201",
            "fax_number": "571-302-8633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANGURA",
        "first_name": "FATMATA",
        "middle_name": "M",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-25",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "27879",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "CP010037T",
            "primary": true
        }
    ],
    "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 11, 2024; 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.