Active NPI
Emily P Stevens
- Physical Therapist
- Fairfax, VA
National Provider Identifier
1891239638
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2305210776
- Practice address
- 8100 Innovation Park Dr Ste LL20
Fairfax, VA 22031-4870 - Phone
- (571) 472-0490
- Fax
- (571) 472-0491
- NPI assigned
- Dec 13, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2305210776 | VA | Primary |
Addresses
Primary practice location
8100 Innovation Park Dr Ste LL20
Fairfax, VA 22031-4870
Mailing address
1492 Kingstream Dr
Herndon, VA 20170-2572
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2305210776 | VA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1481587200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1734652800000",
"number": "1891239638",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1492 KINGSTREAM DR",
"city": "HERNDON",
"state": "VA",
"postal_code": "201702572"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8100 INNOVATION PARK DR STE LL20",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220314870",
"telephone_number": "571-472-0490",
"fax_number": "571-472-0491"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEVENS",
"first_name": "EMILY",
"middle_name": "P",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-12-13",
"last_updated": "2024-12-20",
"certification_date": "2024-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "VA",
"license": "2305210776",
"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 Dec 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.