PROACTIVE PHYSICAL THERAPY AND WELLNESS LLC (NPI# 1982097465) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982097465 |
| Entity Type | Organization |
| Organization Name | PROACTIVE PHYSICAL THERAPY AND WELLNESS LLC |
| Practice Address |
3903 Fair Ridge Dr 211 Fairfax VA 22033-2943 |
| Practice Telephone | 5712943557 |
| Mailing Telephone | 5712943557 |
| Enumeration Date | 2015-03-09 |
| Last Update Date | 2015-08-03 |
| Authorized Official Name | MRS. CHAVONE JOHNSON (PHYSICAL THERAPIST) |
| Authorized Official Telephone | 5712943557 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
2305204873 | VA | Ambulatory Health Care Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | Proactive Physical Therapy and Wellness LLC | 3903 Fair Ridge Drive Suite 211, Fairfax, Virginia 22033 |
| Street Address |
3903 FAIR RIDGE DR 211 |
| City | FAIRFAX |
| State | VA |
| Zip Code | 22033-2943 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962488056 | Rohit Suri | Family Medicine | 3903 Fair Ridge Dr, Suite 219, Fairfax, VA 22033-2943 | 2005-12-20 |
| 1215307400 | Nova Physician Wellness Center Pllc | Family Medicine | 3903 Fair Ridge Dr, Suite 219, Fairfax, VA 22033-2943 | 2015-09-30 |
| 1558779538 | Westfields Dental Group Pl Lc | Dentist | 3903 Fair Ridge Dr, Suite 214, Fairfax, VA 22033-2943 | 2014-07-23 |
| 1649687609 | Westfields Dental | Dentist | 3903 Fair Ridge Dr, Suite 214, Fairfax, VA 22033-2943 | 2014-07-22 |
| 1811335466 | Sara Winnik | Specialist/Technologist | 3903 Fair Ridge Dr, Suite 203, Fairfax, VA 22033-2943 | 2013-06-05 |
| 1669772901 | Advanced Cosmetic Dentistry of Nova | Dentist | 3903 Fair Ridge Dr, Suite # 212, Fairfax, VA 22033-2943 | 2010-11-02 |
| 1669786281 | Carla Milagritos Zamora Rojas | Dentist | 3903 Fair Ridge Dr, Suite 214, Fairfax, VA 22033-2943 | 2010-08-06 |
| 1619290582 | Prima Medicine | Internal Medicine | 3903 Fair Ridge Dr, Suite 218, Fairfax, VA 22033-2943 | 2010-03-08 |
| 1417279589 | Saxena Dental Fairfax, Plc | Dentist | 3903 Fair Ridge Dr, Suite 214, Fairfax, VA 22033-2906 | 2010-02-17 |
| 1609105600 | Michael W. Chang, Dds, Pllc | Dentist | 3903 Fair Ridge Dr, Suite 207, Fairfax, VA 22033-2906 | 2009-12-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366074320 | Han S Yoo | Pharmacist | 12200 West Ox Road, Fairfax, VA 22033 | 2020-02-07 |
| 1386137271 | Ammar Orthodontics Pllc | Dentist | 11702 Fiar Oaks Mall, Upper Floor, Fairfax, VA 22033 | 2018-06-14 |
| 1013360940 | Kellyn Patricia Dodd | Nurse Practitioner | 3903 Fair Ridge Dr Ste 209, Fairfax, VA 22033 | 2016-07-15 |
| 1659721363 | John Du Od PC | Optometrist | 12618 Victoria Station Ct, Fairfax, VA 22033 | 2016-06-14 |
| 1568861904 | Virginia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 12734 Shoppes Lane, Fairfax, VA 22033 | 2014-08-21 |
| 1649696295 | Patrisha Lultschik | Nurse Practitioner | 12375 Lee Jackson Memorial Hwy, Fairfax, VA 22033 | 2014-03-06 |
| 1912321910 | Alyson Huber | Nurse Anesthetist, Certified Registered | 3600 Joseph Siewick Dr., Fairfax, VA 22033 | 2014-02-11 |
| 1578999314 | Aiatulah Surmaty | Optometrist | 11801 Lee Jackson Memorial Hwy, Fairfax, VA 22033 | 2013-09-25 |
| 1356780928 | Ayatallah M. Khafagy | Obstetrics & Gynecology | 3650 Joseph Siewick Dr Suite 203, Fairfax, VA 22033 | 2013-06-17 |
| 1760726665 | Michelle Elise Schwartz | Speech-Language Pathologist | 3507 Curtice Farm Dr, Fairfax, VA 22033 | 2012-11-15 |
| Find all providers in zip 22033 | ||||
| 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 |
| 1104461441 | Primus Physical Therapy Fairfax | Clinic/Center | 3025 Hamaker Ct Ste 103, Fairfax, VA 22031-2221 | 2019-11-11 |
| 1437689932 | Eastern Cranial Affiliates, LLC | Clinic/Center | 10523 Main St, Fairfax, VA 22030-3310 | 2017-06-16 |
| 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.