Virginia Concussion and Pain Physical Therapy, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

VIRGINIA CONCUSSION AND PAIN PHYSICAL THERAPY, LLC

Practice address

10124 W Broad St Ste E
Glen Allen, VA 23060-3330

Phone

(804) 363-7902

NPI assigned

Oct 24, 2025

Last updated

Oct 24, 2025By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Sara Etheredge, PT,DPTNPI 1740412568

Title

Physical Therapist/Owner

Phone

(804) 363-7902

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sara Etheredge, DPT

  • Physical Therapist
  • Glen Allen, VA
  • NPI 1740412568
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1761264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761264000000",
    "number": "1013885771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10124 W BROAD ST STE E",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230603330",
            "telephone_number": "804-363-7902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10124 W BROAD ST STE E",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230603330",
            "telephone_number": "804-363-7902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIRGINIA CONCUSSION AND PAIN PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-24",
        "last_updated": "2025-10-24",
        "certification_date": "2025-10-24",
        "status": "A",
        "authorized_official_last_name": "ETHEREDGE",
        "authorized_official_first_name": "SARA",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST/OWNER",
        "authorized_official_telephone_number": "804-363-7902",
        "authorized_official_credential": "PT,DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Glen Allen, VA
• Providers in Glen Allen, VA by specialty
• Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.