Individual provider Active NPI

Kimberly Marmol, PT

  • Physical Therapist
  • Haymarket, VA
National Provider Identifier
1922408244
Registry record updated Jul 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305211243 Issued in VA
Practice address
6444 Trading SQ
Haymarket, VA 20169-2277
Phone
(571) 885-4616
NPI assigned
Aug 25, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2305211243 VA Primary

Addresses

Primary practice location

6444 Trading SQ
Haymarket, VA 20169-2277

Mailing address

PO Box 69020
Baltimore, MD 21264-2451

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170913000044 VA Practitioner - Physical Therapist in Private Practice 5698996700 Reassigns benefits to 2 organizations
I20180117000077 DC Practitioner - Physical Therapist in Private Practice 5698996700 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tidewater Physical Therapy LLCGroup PAC ID 6406759281, 225 clinicians
Professional Sportscare and Rehab LLCGroup PAC ID 9335137363, 103 clinicians

Practice addresses (Care Compare)

43330 Junction PLZ
Suite 122
Ashburn, VA 20147-3407
Phone (703) 972-1040

6444 Trading SQ
Suite 50
Haymarket, VA 20169-2277
Phone (571) 932-3480

Merit-based Incentive Payment System (MIPS)

Final score
88.48 of 100Reported as group
Quality
86.04
Promoting interoperability
99
Improvement activities
40
Cost
76.38

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Tidewater Physical Therapy, LLC Physical Therapist CurrentSince Apr 1, 2026 Accepting new patients
Tidewater Physical Therapy, LLC Physical Therapist CurrentSince Apr 1, 2026 Accepting new patients
Professional Sportscare & Rehab, LLC Physical Therapist CurrentSince Jun 22, 2017 Accepting new patients
Professional Sportscare & Rehab, LLC Physical Therapist PastSince Jul 5, 2017 Accepting new patients

Locations

1600 Wilson Blvd
Ste 102
Arlington, VA 22209
Phone (301) 464-4500

6444 Trading Sq
Ste 50
Haymarket, VA 20169
Phone (571) 932-3480

11662 Sudley Manor Dr
#50B
Manassas, VA 20109
Phone (571) 321-5720

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": "1408924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500422400000",
    "number": "1922408244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 69020",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212642451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6444 TRADING SQ",
            "city": "HAYMARKET",
            "state": "VA",
            "postal_code": "201692277",
            "telephone_number": "571-885-4616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARMOL",
        "first_name": "KIMBERLY",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-25",
        "last_updated": "2017-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305211243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Haymarket, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2017; 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.