Ivyrehab Sept, LLC
Organization Active NPI Physical Therapist · Charlottesville, VA
NPI 1083155246 · NPPES record last updated Aug 12, 2022
Key facts
- NPI
- 1083155246
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapist 225100000X
- Legal business name
- IVYREHAB SEPT, LLC
- Practice address
- 1622 Timberwood Boulevard
Suite 211
Charlottesville, VA 22911-7573 - Phone
- (434) 202-2830
- Fax
- (434) 529-8457
- NPI assigned
- Mar 20, 2017
- Organization subpart
- No
Authorized official
- Name
- Michael Rucker
- Title
- Ceo
- Phone
- (631) 580-5200
Other NPIs with the same Medicare PAC ID 3
Corporate family (same tax ID) 18
Practitioners 216
-
Andrew G Baldwin, MSPT
-
Chauncey Barham, PT, DPT
-
Crystal Hodges Barnes, PT, DPT
-
Chelsea H Barrick, DPT
-
Gregory Baumstein, PT, DPT
-
Daniel Beale, DPT, PT
-
Christina Ruth Bearden, PHYSICAL THERAPIST
-
Christopher D Berry, DPT
-
Michael T. Blair, PT, DPT, CMTPT
-
Taylor L Blair, DPT
-
Ryan E Bolena, DPT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170607002950 | VA | DME Supplier - Independently-Practicing Physical Therapist |
7911990908 | Practice locations: Charlottesville, VA |
National Provider Directory
- Tax ID family
- Southeastern Physical T
Locations
4668 Pembroke Blvd
Ste 115
Virginia Beach, VA 23455
Phone (757) 648-8562
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | Yes | ||
| Occupational Therapist |
225X00000X |
Addresses
Primary practice location
1622 Timberwood Boulevard
Suite 211
Charlottesville, VA 22911-7573
Mailing address
1311 Mamaroneck Ave Ste 140
White Plains, NY 10605-5224
Phone (914) 294-4050
Other names
- Spectrum Physical Therapy
Other providers in Charlottesville, VA
- Ina S Itzkovitz
- Ivy Commons Family Chiropractic
- Ivy Counseling and Wellness LLC
- Ivy Family Medicine, PLC
- Ivy Road Family Solutions
- Ivyrehab Sept, LLC
- Josephine Emma Iwatsubo
- Siddhanth Iyer
- J Anderson Thomson Jr MD PLC
- J. Anderson Thomson, Jr., M.D.,P.C
All providers in Charlottesville, VA · Physical Therapist in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 12, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.