Individual provider Active NPI

Bestinjohn Kanjiracal Jacob

  • Physical Therapist
  • Henrico, VA
National Provider Identifier
1053982082
Registry record updated Mar 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305214568 Issued in VA
Practice address
2620A Gaskins Rd
Henrico, VA 23238-1402
Phone
(804) 396-6753
Fax
(888) 815-8184
NPI assigned
Jul 9, 2021
Last updated
Mar 28, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2022

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 2305214568 VA Primary

Addresses

Primary practice location

2620A Gaskins Rd
Henrico, VA 23238-1402

Mailing address

350 New Fidelity CT
Garner, NC 27529-2665
Phone (919) 258-2714

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210817000628 VA Practitioner - Physical Therapist in Private Practice 5294130175 Reassigns benefits to 2 organizations
I20230917000001 GA Practitioner - Physical Therapist in Private Practice 5294130175 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
May accept Medicare assignment
Group practices
Unique Care LLCGroup PAC ID 4486940467, 5 clinicians
The Weston Group IncGroup PAC ID 8123936796, 215 clinicians

Practice addresses (Care Compare)

1404 Lawrenceville Suwanee Rd
Suite A1
Lawrenceville, GA 30043-4331
Phone (678) 761-1280

2677 Lawrenceville Hwy
Decatur, GA 30033-2501
Phone (229) 596-8965

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Unique Care LLC Physical Therapist CurrentSince Aug 2, 2023 Accepting new patients
Tidewater Physical Therapy, LLC Physical Therapist CurrentSince Feb 28, 2022 Accepting new patients
Tidewater Physical Therapy, LLC Physical Therapist CurrentSince Feb 28, 2022 Accepting new patients
The Weston Group Inc. Physical Therapist CurrentSince Apr 30, 2025 Accepting new patients
The Weston Group Inc. Physical Therapist CurrentSince Apr 30, 2025 Accepting new patients
Rva Physical Therapy& Sports Rehab, LLC Physical Therapist CurrentSince Aug 9, 2021 Accepting new patients

Locations

1900 The Exchange SE
Ste 400
Atlanta, GA 30339
Phone (678) 631-9584

4465 Nelson Brogdon Blvd
Ste 102
Buford, GA 30518
Phone (678) 761-1280

1100 Reinhardt College Pkwy
Canton, GA 30114
Phone (770) 721-2812

1675 Peachtree Pkwy
Ste 170
Cumming, GA 30041
Phone (678) 761-1280

4470 Satellite Blvd
Ste 208
Duluth, GA 30096
Phone (678) 761-1280

1404 Lawrenceville Suwanee Rd
Ste A1
Lawrenceville, GA 30043
Phone (678) 761-1280

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

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

2620 Gaskins Rd
#A
Henrico, VA 23238
Phone (804) 396-6753

107 Heaths Way Rd
Midlothian, VA 23114
Phone (804) 396-6753

12494 Warwick Blvd
Newport News, VA 23606
Phone (804) 217-9210

4125 Ironbound Rd
Ste 100
Williamsburg, VA 23188
Phone (757) 220-8383

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1625788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648425600000",
    "number": "1053982082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 NEW FIDELITY CT",
            "city": "GARNER",
            "state": "NC",
            "postal_code": "275292665",
            "telephone_number": "919-258-2714",
            "fax_number": "410-648-4878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620A GASKINS RD",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232381402",
            "telephone_number": "804-396-6753",
            "fax_number": "888-815-8184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANJIRACAL JACOB",
        "first_name": "BESTINJOHN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-09",
        "last_updated": "2022-03-28",
        "certification_date": "2022-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305214568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henrico, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2022; 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.