Individual provider Active NPI

Krisna Marie Casino-Chisholm, PHYSICAL THERAPIST

  • Physical Therapist
  • Charlottesville, VA
National Provider Identifier
1073244133
Registry record updated Jun 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305208055 Issued in VA
Practice address
1600 Gordon Ave
Charlottesville, VA 22903-1918
Phone
(434) 293-6136
NPI assigned
Jun 20, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 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 2305208055 VA Primary

Addresses

Primary practice location

1600 Gordon Ave
Charlottesville, VA 22903-1918

Mailing address

3025 Copper Knoll Rd
Charlottesville, VA 22911-7222
Phone (434) 466-5942

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

LicenseStateTypeSpecialty
2305208055VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Martha Jefferson House Physical Therapist CurrentSince Jun 13, 2022 Accepting new patients

Locations

1600 Gordon Ave
Charlottesvle, VA 22903
Phone (434) 245-0372

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1655683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655683200000",
    "number": "1073244133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3025 COPPER KNOLL RD",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229117222",
            "telephone_number": "434-466-5942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 GORDON AVE",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229031918",
            "telephone_number": "434-293-6136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASINO-CHISHOLM",
        "first_name": "KRISNA MARIE",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-20",
        "last_updated": "2022-06-20",
        "certification_date": "2022-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305208055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2022; 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.