Individual provider Active NPI

Sheri Jean

  • Physical Therapist
  • Reston, VA
National Provider Identifier
1962067041
Registry record updated Apr 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305213917 Issued in VA
Practice address
11800 Sunrise Valley Dr Ste 1
Reston, VA 20191-5302
Phone
(703) 709-1116
NPI assigned
May 5, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physical Therapist 225100000X 2305213917 VA Primary

Addresses

Primary practice location

11800 Sunrise Valley Dr Ste 1
Reston, VA 20191-5302

Mailing address

1807 Key Blvd Apt 522
Arlington, VA 22201-3235

Other practice location 1

8101 Hinson Farm Rd Ste 401
Alexandria, VA 22306-3409
Phone (703) 664-7660

Other practice location 2

11800 Sunrise Valley Dr Ste 1
Reston, VA 20191-5302
Phone (703) 709-1116

Other practice location 3

4040 Fairfax Dr
Arlington, VA 22203-1613
Phone (703) 292-4060

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230510001540 DC Practitioner - Physical Therapist in Private Practice 7214393677 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
May accept Medicare assignment
Group practices
Virginia Therapy and Fitness CenterGroup PAC ID 3072680628, 11 clinicians

Practice addresses (Care Compare)

11800 Sunrise Valley Dr
Suite 100
Reston, VA 20191-5309
Phone (703) 709-1116

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2305213917VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Breakthrough Physical Therapy PLLC CurrentSince Apr 28, 2024 Accepting new patients
Virginia Therapy & Fitness Center CurrentSince Mar 23, 2023 Accepting new patients

Locations

11800 Sunrise Valley Dr
Ste 100
Reston, VA 20191
Phone (703) 709-1116

Organizations & group practices 2

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": "1557014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713657600000",
    "number": "1962067041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1807 KEY BLVD APT 522",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222013235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11800 SUNRISE VALLEY DR STE 1",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201915302",
            "telephone_number": "703-709-1116"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8101 Hinson Farm Rd Ste 401",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "VA",
            "postal_code": "223063409",
            "country_code": "US",
            "telephone_number": "703-664-7660",
            "fax_number": "703-664-7663",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11800 Sunrise Valley Dr Ste 1",
            "address_purpose": "LOCATION",
            "city": "Reston",
            "state": "VA",
            "postal_code": "201915302",
            "country_code": "US",
            "telephone_number": "703-709-1116",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4040 Fairfax Dr",
            "address_purpose": "LOCATION",
            "city": "Arlington",
            "state": "VA",
            "postal_code": "222031613",
            "country_code": "US",
            "telephone_number": "703-292-4060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JEAN",
        "first_name": "SHERI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-05",
        "last_updated": "2024-04-21",
        "certification_date": "2024-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305213917",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 21, 2024; 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.