Active NPI
Jersey-Roy Reyes
- Physical Therapy Assistant
- Fairfax, VA
National Provider Identifier
1922348812
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 2306603473
- Practice address
- 4320 Forest Hill Dr
Fairfax, VA 22030-5766 - Phone
- (703) 667-9800
- NPI assigned
- Feb 28, 2013
- Last updated
- Feb 28, 2013
- Sex
- Male
- 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 Therapy Assistant | 225200000X | 2306603473 | VA | Primary |
Addresses
Primary practice location
4320 Forest Hill Dr
Fairfax, VA 22030-5766
Mailing address
14563 Golden Oak Rd
Centreville, VA 20121-2261
Phone (202) 413-5984
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 |
|---|---|---|---|
| 2306603473 | VA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1362009600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1362009600000",
"number": "1922348812",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14563 GOLDEN OAK RD",
"city": "CENTREVILLE",
"state": "VA",
"postal_code": "201212261",
"telephone_number": "202-413-5984"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4320 FOREST HILL DR",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220305766",
"telephone_number": "703-667-9800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYES",
"first_name": "JERSEY-ROY",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-02-28",
"last_updated": "2013-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "VA",
"license": "2306603473",
"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 Feb 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.