Individual provider Active NPI

Nelson A Min, MSPT

  • Physical Therapist
  • Reston, VA
National Provider Identifier
1912996752
Registry record updated Apr 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305204261 Issued in VA
Practice address
1760 Reston Pkwy
Suite 403
Reston, VA 20190-3388
Phone
(703) 230-1760
Fax
(203) 230-1761
NPI assigned
Oct 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2008

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 2305204261 VA Primary
Physical Therapist 225100000X J1-0001744 DE

Addresses

Primary practice location

1760 Reston Pkwy
Suite 403
Reston, VA 20190-3388

Mailing address

1760 Reston Pkwy
Suite 403
Reston, VA 20190-3388
Phone (703) 230-1760

Other identifiers 4

IdentifierTypeStateIssuer
701966OtherVANCPPO
P00163524-DC3456OtherVARAILROAD MEDICARE
249890OtherVAANTHEM
7060-0001OtherVACAREFIRST BCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050523001177 DC Practitioner - Physical Therapist in Private Practice 5698715076 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Miami, LM Miller School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bodies in Motion Physical Therapy II, LLCGroup PAC ID 9830296367, 11 clinicians

Practice addresses (Care Compare)

1760 Reston Pkwy
Suite 403
Reston, VA 20190-3360
Phone (703) 230-1760

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
J1-0001744DEMDPhysical Therapist
2305204261VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bodies in Motion Physical Therapy II, LLC Physical Therapist CurrentSince Oct 23, 2006 Accepting new patients
Bodies in Motion Physical Therapy, LLC Physical Therapist PastSince Aug 10, 2006 Accepting new patients
Christiana Care Health Initiatives Past Accepting new patients
Christiana Care Health Initiatives Past Accepting new patients
Christiana Care Health Initiatives, Inc Physical Therapist Past Accepting new patients

Locations

1760 Reston Pkwy
Ste 403
Reston, VA 20190
Phone (703) 230-1760

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1129248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208304000000",
    "number": "1912996752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1760 RESTON PKWY",
            "address_2": "SUITE 403",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201903388",
            "telephone_number": "703-230-1760",
            "fax_number": "203-230-1761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1760 RESTON PKWY",
            "address_2": "SUITE 403",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201903388",
            "telephone_number": "703-230-1760",
            "fax_number": "203-230-1761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIN",
        "first_name": "NELSON",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-14",
        "last_updated": "2008-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305204261",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "DE",
            "license": "J1-0001744",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPPO",
            "identifier": "701966",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00163524-DC3456",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "249890",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS",
            "identifier": "7060-0001",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reston, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2008; 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.