NPIMap

Organization Active NPI

Progressive Physical Therapy, LLC

  • Physical Therapist
  • Vienna, VA
National Provider Identifier
1972134831
Registry record updated Jan 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PROGRESSIVE PHYSICAL THERAPY, LLC
Practice address
111 Church St NW Ste 201
Vienna, VA 22180-4536
Phone
(703) 272-8340
Fax
(703) 272-8365
NPI assigned
Jan 30, 2020
Organization subpart
Yes
Parent organization
PHOENIX REHABILITATION AND HEALTH SERVICES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 10, 2022

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

Authorized official

Name
Lauren Lau
Title
Credentialing Director
Phone
(724) 989-4564

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

111 Church St NW Ste 201
Vienna, VA 22180-4536

Mailing address

430 Innovation Dr
Blairsville, PA 15717-8096
Phone (724) 343-4060

Other names 1

  • PHOENIX Rehabilitation and Health Services, LLC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Phoenix Physical Therapy27 organizations share this tax ID, including this one
Part of
Phoenix Rehabilitation and Health Services Inc

Other organizations with this tax ID 26

Organizations that report the same tax identification number in the National Provider Directory.

View all 26

Locations

111 Church St NW
Ste 201
Vienna, VA 22180
Phone (703) 272-8340

111 Church St NW
Vienna, VA 22180

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1580342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641772800000",
    "number": "1972134831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 INNOVATION DR",
            "city": "BLAIRSVILLE",
            "state": "PA",
            "postal_code": "157178096",
            "telephone_number": "724-343-4060",
            "fax_number": "724-343-4069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 CHURCH ST NW STE 201",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221804536",
            "telephone_number": "703-272-8340",
            "fax_number": "703-272-8365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRESSIVE PHYSICAL THERAPY, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PHOENIX REHABILITATION AND HEALTH SERVICES, INC.",
        "enumeration_date": "2020-01-30",
        "last_updated": "2022-01-10",
        "certification_date": "2022-01-10",
        "status": "A",
        "authorized_official_last_name": "LAU",
        "authorized_official_first_name": "LAUREN",
        "authorized_official_title_or_position": "CREDENTIALING DIRECTOR",
        "authorized_official_telephone_number": "724-989-4564"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PHOENIX Rehabilitation and Health Services, LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PHOENIX Rehabilitation and Health Services, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vienna, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 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.