Blue Room PT Inc.

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

BLUE ROOM PT INC.

Doing business as

Blue Room Physical Therapy

Practice address

8530 Amanda PL
Vienna, VA 22180-6873

Phone

(240) 505-5544

Fax

(301) 365-4203

NPI assigned

Apr 26, 2017

Organization subpart

No

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

Authorized official

Name

Mr. Conrad Sultan Osipowicz

Title

President

Phone

(240) 505-5544

Specialties & licenses 1

Addresses

Other names 1

• Blue Room Physical Therapy Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Chaivut Vorachacreyanan, PT

  • Physical Therapist
  • Arlington, VA
  • NPI 1083832554
  NPD (past)
• Michael R Twomey, PT

  • Physical Therapist
  • Lanham, MD
  • NPI 1568600807
  NPD (past)

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

{
    "created_epoch": "1493164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493164800000",
    "number": "1902331085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13505 DULLES TECHNOLOGY DR",
            "address_2": "SUITE 2",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201713401",
            "telephone_number": "240-505-5544",
            "fax_number": "301-365-4203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8530 AMANDA PL",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221806873",
            "telephone_number": "240-505-5544",
            "fax_number": "301-365-4203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE ROOM PT INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-26",
        "last_updated": "2017-04-26",
        "status": "A",
        "authorized_official_last_name": "OSIPOWICZ",
        "authorized_official_first_name": "CONRAD",
        "authorized_official_middle_name": "SULTAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "240-505-5544",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blue Room Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• BJB Physical Therapy
• Gary Blabey, DC
• Amina Blackson
• Brittany Aprelle Bland, RBT
• Blooming Future Behavioral Health and Family Services
• Justine Marie Bofill, PT, DPT
• Emily Kirby Boland, MSW
• Amy Katherine Boles, CRNA
• Christopher E Bonacci, D.D.S., M.D.
• Marguerite Bonadies

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2017; 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.