Jacqueline Nyren, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2305006280 Issued in VA

Practice address

46161 Westlake Dr
Suite 330
Sterling, VA 20165-5871

Phone

(703) 444-9562

Fax

(703) 430-2124

NPI assigned

Aug 22, 2006

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

Other names 1

• Jacqueline Frustace Former name

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": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464825600000",
    "number": "1891801759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46161 WESTLAKE DR",
            "address_2": "SUITE 330",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201655871",
            "telephone_number": "703-444-9562",
            "fax_number": "703-430-2124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46161 WESTLAKE DR",
            "address_2": "SUITE 330",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201655871",
            "telephone_number": "703-444-9562",
            "fax_number": "703-430-2124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYREN",
        "first_name": "JACQUELINE",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-22",
        "last_updated": "2016-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305006280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "FRUSTACE",
            "credential": "MPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2016; 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.