MEDICARE: BODY BY GEOFF

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	106H00000X	Marriage & Family Therapist
2	111NR0400X	Rehabilitation Chiropractor
3	133N00000X	Nutritionist
4	225100000X	Physical Therapist
5	225700000X	Massage Therapist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	239710	OTHER	VA	ANTHEM
2	N138	OTHER	VA	CAREFIRST

General Provider Information

NPI Number	:	1144371915
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BODY BY GEOFF

Provider Business Mailing Address
First Line	:	1609 WASHINGTON PLZ N STE B
Second Line	:	LAKE ANNE VILLAGE CENTER
City	:	RESTON
State	:	VA
Zip	:	20190-4346
Country	:	US
Telephone Number	:	703-464-5559
Fax Number	:	703-464-5549

Provider Business Practice Location Address
First Line	:	1609 WASHINGTON PLZ N STE B
Second Line	:	LAKE ANNE VILLAGE CENTER
City	:	RESTON
State	:	VA
Zip	:	20190-4346
Country	:	US
Telephone Number	:	703-464-5559
Fax Number	:	703-464-5549

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JAMES KIMON SMITH
Credential	:
Telephone Number	:	703-464-5559

Provider Enumeration Date	:	01/16/2007
Last Update Date	:	09/11/2025

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Directions to “BODY BY GEOFF ” Practice Location

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