Full Distance – Physical Therapist, NPI 1881139079
Physical Therapist
Main info
Contacts
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Full Distance
17909 N SHORE DR
PURCELLVILLE, VA 201323980
Phone: (540) 931-3037
Type: Mailing
130 S 20TH ST
PURCELLVILLE, VA 201323301
Phone: (540) 931-3037
Fax: (571) 363-2753
Type: Location
100 RETREAT LN
HUDDLESTON, VA 241043579
Phone: (540) 328-1983
Fax: (571) 363-2753
Type: Location
PO BOX 378
HUDDLESTON, VA 241040378
Phone: (540) 328-1983
Fax: (571) 363-2753
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: 2017-04-03
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-02-29 (833 days ago).
Enrollment records
1
Earliest due date
2024-02-29
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 |
|---|---|---|---|---|
| O20170403002454 | O | Physical/Occupational Therapy Group In Private Practice | VA | 2024-02-29 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 20132)
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