| Goodwin Rehabilitation | |
|
5000 Fairbanks Ave Alexandria VA 22311-1246 | |
| (703) 578-7195 | |
| Not Available |
| Full Name | Goodwin Rehabilitation |
|---|---|
| Speciality | Clinic/Center |
| Location | 5000 Fairbanks Ave, Alexandria, Virginia |
| Authorized Official Name and Position | Melinda T Gren (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7038241390 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Goodwin Rehabilitation 5000 Fairbanks Ave Alexandria VA 22311-1246 Ph: (703) 797-3869 | Goodwin Rehabilitation 5000 Fairbanks Ave Alexandria VA 22311-1246 Ph: (703) 578-7195 |
| NPI Number | 1144969296 |
|---|---|
| Provider Enumeration Date | 05/27/2022 |
| Last Update Date | 10/31/2022 |
| Medicare PECOS PAC ID | 7214366244 |
|---|---|
| Medicare Enrollment ID | O20221121002389 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144969296 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| 261QP2000X | Clinic/center - Physical Therapy | (* (Not Available)) | Secondary |
| Provider Name | Melinda T Gren |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1215163621 PECOS PAC ID: 8325190382 Enrollment ID: I20130730000405 |
| Provider Name | Meredith Kotoski |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1710323951 PECOS PAC ID: 8729321930 Enrollment ID: I20190509001930 |
| Provider Name | Kang Tzu Lee |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1437311396 PECOS PAC ID: 7416231048 Enrollment ID: I20210727000029 |
| Provider Name | Gianna N White |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1427784057 PECOS PAC ID: 9133502883 Enrollment ID: I20220813000417 |
| Provider Name | Alexandra B Young |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1326599804 PECOS PAC ID: 9436526001 Enrollment ID: I20221110002759 |
| Provider Name | Shayna A Friedman |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1043936131 PECOS PAC ID: 0244607810 Enrollment ID: I20221110002808 |
| Provider Name | Olivia J Muro |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1255993671 PECOS PAC ID: 2860869443 Enrollment ID: I20221110002977 |
| Provider Name | Jessica Feldman |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1134763667 PECOS PAC ID: 7810365905 Enrollment ID: I20221121002565 |
| Provider Name | Lia A Poynor |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1730805060 PECOS PAC ID: 5597135996 Enrollment ID: I20221229001410 |
| Provider Name | Sara A Mowery |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1538673108 PECOS PAC ID: 1254705643 Enrollment ID: I20230327001689 |
| Provider Name | Shonda R Nelson |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1255672150 PECOS PAC ID: 9335506872 Enrollment ID: I20230529000077 |
| Provider Name | Sydney A Carlson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1558046441 PECOS PAC ID: 6709247117 Enrollment ID: I20230802000642 |
| Provider Name | Allison Jarboe |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1164985271 PECOS PAC ID: 9638532153 Enrollment ID: I20230911002367 |
| Provider Name | Sarah S Tatlonghari |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1013310119 PECOS PAC ID: 3779938006 Enrollment ID: I20231006000858 |
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