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

Miss. Jackalyn Nicole Peterson, DPT

Individual provider Specialist · NPI 1013241769

Miss. Jackalyn Nicole Peterson, DPT is a Physical Therapist in Private Practice in Fairfax, Virginia. Qualified in 2009, 17 years ago. Practices with Excel Rehabilitation PLLC, a 9-clinician group and accepts Medicare assignment. Licensed in Virginia.

Years since qualifying
17
Licensed in
VA
In the registry since
2009
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

9860 Fairfax Blvd Ste 1
Fairfax, VA 22030-1737
Phone: (703) 383-1616
Fax: (703) 383-1166
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence 2305206191 (VA)

Record details

NPI number1013241769
Entity typeIndividual (Type 1)
GenderFemale
Credentials DPT
Sole proprietorNo
NPI enumeratedSeptember 29, 2009
Last updated in NPPESNovember 14, 2016

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2009 (17 years in practice)
Group practice Excel Rehabilitation Pllc — 9 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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