Active NPI
Laura Beth Walters, DPT
- Physical Therapist
- Woodbridge, VA
National Provider Identifier
1962799049
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2305207662
- Practice address
- 4565 Daisy Reid Ave Ste 215
Woodbridge, VA 22192-5670 - Phone
- (703) 523-8752
- NPI assigned
- Jul 8, 2011
- Last updated
- Jul 13, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT 36829 | CA | |
| Physical Therapist | 225100000X | 2305207662 | VA | Primary |
Addresses
Primary practice location
4565 Daisy Reid Ave Ste 215
Woodbridge, VA 22192-5670
Mailing address
3717 5TH Ave
Altoona, PA 16602-1706
Phone (814) 944-8678
Other practice location 1
555 Washington St
San Diego, CA 92103-2289
Phone (619) 260-8300
Other practice location 2
12191 Clipper Dr
Lake Ridge, VA 22192-2237
Phone (703) 496-3486
Other practice location 3
95 Dunn Dr Ste 123
Stafford, VA 22556-1503
Phone (703) 523-9565
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT 36829 | CA | MD | Physical Therapist |
| 2305207662 | VA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1310083200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1657670400000",
"number": "1962799049",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3717 5TH AVE",
"city": "ALTOONA",
"state": "PA",
"postal_code": "166021706",
"telephone_number": "814-944-8678"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4565 DAISY REID AVE STE 215",
"city": "WOODBRIDGE",
"state": "VA",
"postal_code": "221925670",
"telephone_number": "703-523-8752"
}
],
"practiceLocations": [
{
"address_1": "555 Washington St",
"address_purpose": "LOCATION",
"city": "San Diego",
"state": "CA",
"postal_code": "921032289",
"country_code": "US",
"telephone_number": "619-260-8300",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "12191 Clipper Dr",
"address_purpose": "LOCATION",
"city": "Lake Ridge",
"state": "VA",
"postal_code": "221922237",
"country_code": "US",
"telephone_number": "703-496-3486",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "95 Dunn Dr Ste 123",
"address_purpose": "LOCATION",
"city": "Stafford",
"state": "VA",
"postal_code": "225561503",
"country_code": "US",
"telephone_number": "703-523-9565",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WALTERS",
"first_name": "LAURA",
"middle_name": "BETH",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-07-08",
"last_updated": "2022-07-13",
"certification_date": "2022-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT 36829",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "VA",
"license": "2305207662",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodbridge, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.