PRIMUS PHYSICAL THERAPY FAIRFAX (NPI# 1104461441) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104461441 |
| Entity Type | Organization |
| Organization Name | PRIMUS PHYSICAL THERAPY FAIRFAX |
| Practice Address |
3025 Hamaker Ct Ste 103 Fairfax VA 22031-2221 |
| Mailing Address |
6101 Redwood Square Ctr Ste 202 Centreville VA 20121-4269 |
| Practice Telephone | 7035484400 |
| Practice Fax Number | 7039950284 |
| Mailing Telephone | 7035436660 |
| Enumeration Date | 2019-11-11 |
| Last Update Date | 2019-11-11 |
| Authorized Official Name | KAYLA ROBISON (CLINICAL SERVICES DIRECTOR) |
| Authorized Official Telephone | 7035484400 |
| Authorized Official Credential | DPT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
Ambulatory Health Care Facilities |
| Street Address |
3025 HAMAKER CT STE 103 |
| City | FAIRFAX |
| State | VA |
| Zip Code | 22031-2221 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952421430 | Oana Balasa | Physical Therapist | 3025 Hamaker Ct Ste 103, Fairfax, VA 22031-2221 | 2007-03-30 |
| 1376908624 | Set Sports Physical Therapy, LLC | Physical Therapist | 3025 Hamaker Ct Ste 103, Fairfax, VA 22031-2221 | 2015-12-30 |
| 1588995674 | Kayla Ann Robison | Physical Therapist | 3025 Hamaker Ct Ste 103, Fairfax, VA 22031-2221 | 2010-01-29 |
| 1740474675 | Jennifer Johnson | Physical Therapy Assistant | 3025 Hamaker Ct Ste 103, Fairfax, VA 22031-2221 | 2007-09-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902414105 | Su Jung Kang | Dentist | 9661-c Main Street, Fairfax, VA 22031 | 2020-07-14 |
| 1346896347 | Fuling Guo | Acupuncturist | 3013 James St, Fairfax, VA 22031 | 2019-08-15 |
| 1902458797 | Kayla Callister | Psychologist | 2270 Willow Oaks Corporate Drive, Fairfax, VA 22031 | 2019-07-11 |
| 1790349801 | Fairfax Dental Esthetics | Dentist | 9621 Fairfax Blvd., Fairfax, VA 22031 | 2019-04-24 |
| 1417427675 | Kathryn Yen Ho | Speech-Language Pathologist | 8270 Willow Oaks Corporate Drive Suite 2127, Falls Church, VA 22031 | 2018-11-30 |
| 1932681376 | Joanne Towers | Physician Assistant | 3025 Hamaker Court Suite 300, Fairfax, VA 22031 | 2018-09-01 |
| 1790262020 | S Renee Dennis | Nurse Practitioner | 8316 Arlington Blvd Ste 500, Fairfax, VA 22031 | 2018-07-19 |
| 1013493451 | Elizabeth Joan Dwyer | Physician Assistant | 3023 Hamaker Ct., Suite 500, Fairfax, VA 22031 | 2018-07-18 |
| 1316432669 | Delta Pharm LLC | Pharmacy | 8316 Arlington Blvd Ste 100, Fairfax, VA 22031 | 2018-06-28 |
| 1629567656 | Laura Breeden | Acupuncturist | 3846 Lyndhurst Dr Apt 301, Fairfax, Va, VA 22031 | 2018-05-04 |
| Find all providers in zip 22031 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932753811 | Resurgent Sports Rehab LLC | Clinic/Center | 8500 Executive Park Ave Ste 100, Fairfax, VA 22031-2228 | 2019-07-29 |
| 1114468188 | Occupational Health Centers of The Southwest, P.a., P.C. | Clinic/Center | 8613 Lee Hwy, Suite 110, Fairfax, VA 22031-2171 | 2017-03-10 |
| 1235558347 | Dynamic Rehab Inc | Clinic/Center | 8316 Arlington Blvd Ste 520, Fairfax, VA 22031-5216 | 2014-04-16 |
| 1255771515 | Hamid Espandyari | Clinic/Center | 8316 Arlington Blvd #520, Fairfax, VA 22031 | 2013-07-01 |
| 1780933028 | Ace Physical Therapy & Sports Medicine Institute, LLC | Clinic/Center | 12011 Lee Jackson Memorial Hwy Ste 101, Fairfax, VA 22033-3310 | 2012-08-31 |
| 1649305277 | Applied Physical Therapy, Inc | Clinic/Center | 10373a Democracy Ln, Fairfax, VA 22030-2505 | 2007-02-23 |
| 1437689932 | Eastern Cranial Affiliates, LLC | Clinic/Center | 10523 Main St, Fairfax, VA 22030-3310 | 2017-06-16 |
| 1982097465 | Proactive Physical Therapy and Wellness LLC | Clinic/Center | 3903 Fair Ridge Dr, 211, Fairfax, VA 22033-2943 | 2015-03-09 |
| 1609211036 | Fitness and Rehabilitation, Inc. | Clinic/Center | 10400 Eaton Pl, Suite 312, Fairfax, VA 22030-2208 | 2013-04-29 |
| 1336366079 | The Temple Foundation Inc | Clinic/Center | 9229 Arlington Blvd, Fairfax, VA 22031-2504 | 2007-04-20 |
| Find all providers in FAIRFAX | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.