Provider Demographics
NPI:1336293083
Name:SEMPLE, BARBARA KERKOFF (PT)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:KERKOFF
Last Name:SEMPLE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8986 LORTON STATION BLVD
Mailing Address - Street 2:STE 202
Mailing Address - City:LORTON
Mailing Address - State:VA
Mailing Address - Zip Code:22079-4753
Mailing Address - Country:US
Mailing Address - Phone:703-546-0013
Mailing Address - Fax:703-546-0014
Practice Address - Street 1:8986 LORTON STATION BLVD
Practice Address - Street 2:STE 202
Practice Address - City:LORTON
Practice Address - State:VA
Practice Address - Zip Code:22079-4753
Practice Address - Country:US
Practice Address - Phone:703-546-0013
Practice Address - Fax:703-546-0014
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15580225100000X
VA2305210126225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD338063OtherMAMSI LIFE MD IPA
DCS9860008OtherCF BLUE CROSS BLUE SHIELD
MDLK24ATOtherCF BLUE CROSS BLUE SHIELD
DCS9860008OtherCF BLUE CROSS BLUE SHIELD