NPIMap

Organization Active NPI

BPT Wellness

  • Physical Therapist
  • Herndon, VA
National Provider Identifier
1942791439
Registry record updated Jun 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305204402 Issued in VA
Legal business name
BPT WELLNESS
Practice address
657 Nathaniel Chase LN
Herndon, VA 20170-4970
Phone
(571) 235-7898
Fax
(206) 339-2959
NPI assigned
May 21, 2018
Last updated
Jun 9, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2022

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

Authorized official

Name
Broadwin B Adesegun, DPTNPI 1548349996
Title
Owner
Phone
(703) 826-3743

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2305204402 VA Primary

Addresses

Primary practice location

657 Nathaniel Chase LN
Herndon, VA 20170-4970

Mailing address

657 Nathaniel Chase LN
Herndon, VA 20170-4970
Phone (703) 826-3743

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1526860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654732800000",
    "number": "1942791439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "657 NATHANIEL CHASE LN",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201704970",
            "telephone_number": "703-826-3743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "657 NATHANIEL CHASE LN",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201704970",
            "telephone_number": "571-235-7898",
            "fax_number": "206-339-2959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BPT WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-21",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A",
        "authorized_official_last_name": "ADESEGUN",
        "authorized_official_first_name": "BROADWIN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "703-826-3743",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305204402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Herndon, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2022; 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.