KELLIE N WADSWORTH (DPT) – Physical Therapist, NPI 1306211347
Physical Therapist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,100 PHYSICAL THERAPIST IN PRIVATE PRACTICE in VA
Provider Addresses for KELLIE N WADSWORTH (DPT)
14605 POTOMAC BRANCH DR
SUITE 300
WOODBRIDGE, VA 221913336
Phone: (703) 490-1112
Fax: (703) 878-8735
Type: Mailing
10716 RICHMOND HWY STE 103
LORTON, VA 220792645
Phone: (703) 892-6500
Fax: (703) 521-3415
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2016-01-30
PECOS data refreshed: 2026-06-15
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20160119002388 | I | Physical Therapist In Private Practice | DC | TBD |
| I20160130000101 | I | Physical Therapist In Private Practice | VA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 97530 | Therapy procedure using functional activities | 472 | 53 | $0 |
| 97110 | Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | 360 | 52 | $0 |
| 97112 | Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes | 315 | 50 | $0 |
| 97016 | Application of blood vessel compression device | 161 | 27 | $0 |
| 97140 | Therapy procedure using manual technique, each 15 minutes | 95 | 35 | $0 |
Insurance plans in this area (ZIP 22191)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | VA | |
| Physician Assistant | VA | |
| Orthopedic Surgery | VA | |
| Physical Therapist In Private Practice | VA | |
| Orthopedic Surgery, Sports Medicine | VA | |
| Orthopedic Surgery | VA | |
| - | VA | |
| Physician Assistant | VA | |
| Orthopedic Surgery | PA | |
| Physician Assistant | VA |
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