Individual provider Active NPI

Trevor Wesley Goring, PT,DPT

  • Physical Therapist
  • Norfolk, VA
National Provider Identifier
1053652578
Registry record updated Nov 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305207835 Issued in VA
Practice address
3509 Granby St Ste B
Norfolk, VA 23504-1312
Phone
(757) 423-8885
Fax
(757) 423-8886
NPI assigned
Mar 7, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2305207835 VA Primary

Addresses

Primary practice location

3509 Granby St Ste B
Norfolk, VA 23504-1312

Mailing address

PO Box 412307
Boston, MA 02241-2307
Phone (914) 294-4050

Other practice location 1

7190 Chapman Dr
Hayes, VA 23072-3416
Phone (804) 642-3028

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181126000269 VA Practitioner - Physical Therapist in Private Practice 7214174473 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Howard University College of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ivyrehab Sept, LLCGroup PAC ID 7911990908, 216 clinicians

Practice addresses (Care Compare)

3509 Granby St
Suite B
Norfolk, VA 23504-1312
Phone (757) 423-8885

Merit-based Incentive Payment System (MIPS)

Final score
88.16 of 100Reported as group
Quality
85.78
Promoting interoperability
99
Improvement activities
40
Cost
75.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2305207835VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Tidewater Physical Therapy, LLC Physical Therapist CurrentSince Sep 10, 2018 Accepting new patients
Ivyrehab Sept, LLC Physical Therapist CurrentSince Nov 1, 2024 Accepting new patients
Tidewater Physical Therapy, LLC Physical Therapist CurrentSince Sep 10, 2018 Accepting new patients
Ivyrehab Sept, LLC Physical Therapist CurrentSince Nov 1, 2024 Accepting new patients

Locations

350 New Fidelity Ct
Garner, NC 27529
Phone (919) 373-2919

2275 Beech Ave
Buena Vista, VA 24416
Phone (540) 466-1000

10128 W Broad St
Bldg Iii
Glen Allen, VA 23060
Phone (804) 217-9210

7190 Chapman Dr
Hayes, VA 23072
Phone (800) 464-2302

3509 Granby St
#B
Norfolk, VA 23504
Phone (757) 423-8885

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1362614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732665600000",
    "number": "1053652578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 412307",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022412307",
            "telephone_number": "914-294-4050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3509 GRANBY ST STE B",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235041312",
            "telephone_number": "757-423-8885",
            "fax_number": "757-423-8886"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7190 Chapman Dr",
            "address_purpose": "LOCATION",
            "city": "Hayes",
            "state": "VA",
            "postal_code": "230723416",
            "country_code": "US",
            "telephone_number": "804-642-3028",
            "fax_number": "804-642-3467",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORING",
        "first_name": "TREVOR",
        "middle_name": "WESLEY",
        "credential": "PT,DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-07",
        "last_updated": "2024-11-27",
        "certification_date": "2024-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305207835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.