Individual provider Active NPI

Eric Zwarycz

  • Physical Therapy Assistant
  • Fork Union, VA
National Provider Identifier
1063980449
Registry record updated Nov 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2306604716 Issued in VA
Practice address
4238 James Madison Hwy
Fork Union, VA 23055
Phone
(434) 842-2916
NPI assigned
Nov 5, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2306604716 VA Primary

Addresses

Primary practice location

4238 James Madison Hwy
Fork Union, VA 23055

Mailing address

2111 Woodman Oaks LN
Powhatan, VA 23139-7139

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2306604716VAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1541376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541376000000",
    "number": "1063980449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2111 WOODMAN OAKS LN",
            "city": "POWHATAN",
            "state": "VA",
            "postal_code": "231397139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4238 JAMES MADISON HWY",
            "city": "FORK UNION",
            "state": "VA",
            "postal_code": "23055",
            "telephone_number": "434-842-2916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZWARYCZ",
        "first_name": "ERIC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-05",
        "last_updated": "2018-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "VA",
            "license": "2306604716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fork Union, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2018; 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.