Healthcare Provider Details

I. General information

NPI: 1720752504
Provider Name (Legal Business Name): NATIONAL REHABILITATION HOSPITAL, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2021
Last Update Date: 01/11/2024
Certification Date: 01/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6805 INDUSTRIAL RD STE 3100
SPRINGFIELD VA
22151-4206
US

IV. Provider business mailing address

102 IRVING ST NW ATTN: MHPT PAYOR ENROLLMENT
WASHINGTON DC
20010-2949
US

V. Phone/Fax

Practice location:
  • Phone: 703-256-2171
  • Fax: 703-256-2172
Mailing address:
  • Phone: 301-540-6140
  • Fax: 301-540-5190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. JOHN ROCKWOOD
Title or Position: PRESIDENT
Credential:
Phone: 301-540-6140