Active NPI
Courtney Bacca
- Physical Therapist
- Virginia Beach, VA
National Provider Identifier
1063708949
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2305206796
- Practice address
- 5869 Walker Rd
Virginia Beach, VA 23464-2005 - Phone
- (757) 490-3223
- NPI assigned
- Jun 20, 2011
- Last updated
- Oct 28, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2305206796 | VA | Primary |
Addresses
Primary practice location
5869 Walker Rd
Virginia Beach, VA 23464-2005
Mailing address
5869 Walker Rd
Virginia Beach, VA 23464-2005
Phone (757) 490-3223
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2305206796 | VA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Restorative Physical Therapy & Wellness LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba JRose Integrative Therapy
- Physical Therapy Clinic/Center
- Chesapeake, VA
- NPI 1770955312
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308528000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1382918400000",
"number": "1063708949",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5869 WALKER RD",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234642005",
"telephone_number": "757-490-3223"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5869 WALKER RD",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234642005",
"telephone_number": "757-490-3223"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BACCA",
"first_name": "COURTNEY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-06-20",
"last_updated": "2013-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "VA",
"license": "2305206796",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Virginia Beach, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.