Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Roy A Etta, PT, DPT

Individual provider Physical Therapist · NPI 1972464055

Dr. Roy A Etta, PT, DPT is a Physical Therapist in Private Practice in Brambleton, Virginia. Qualified in 2025, 1 year ago. Practices with Jackson Clinics Limited Partnership, a 115-clinician group and accepts Medicare assignment. Licensed in Tennessee and Virginia.

Years since qualifying
1
Licensed in
TN, VA
In the registry since
2025
Specialties on file
2
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

42365 Soave Dr Ste 200
Brambleton, VA 20148-4888
Phone: (571) 349-3116
Fax: (571) 349-3119
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence CP051278T (VA)
Physical Therapist Taxonomy 225100000X · Licence 16530 (TN)

Record details

NPI number1972464055
Entity typeIndividual (Type 1)
GenderMale
Credentials PT , DPT
Sole proprietorNo
NPI enumeratedNovember 19, 2025
Last updated in NPPESNovember 26, 2025
Certification dateNovember 26, 2025
Mailing address12701 Fair Lakes Cir Ste 102, Fairfax, VA 22033-4913

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Jackson Clinics Limited Partnership — 115 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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