Organization Active NPI

Advanced Physical Therapy of Virginia Inc

  • Physical Therapist
  • Salem, VA
National Provider Identifier
1083623284
Registry record updated Dec 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
230500588 Issued in VA
Legal business name
ADVANCED PHYSICAL THERAPY OF VIRGINIA INC
Practice address
1620 Apperson Dr
Salem, VA 24153-7217
Phone
(540) 444-0291
Fax
(540) 444-0293
NPI assigned
Aug 5, 2006
Last updated
Dec 2, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2014

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

Authorized official

Name
Mr. Thomas Lee Ellexson, PTNPI 1386657799
Title
Owner
Phone
(540) 444-0291

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 230500588 VA Primary

Addresses

Primary practice location

1620 Apperson Dr
Salem, VA 24153-7217

Mailing address

1620 Apperson Dr
Salem, VA 24153-7217
Phone (540) 444-0291

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070620000306 VA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 7214931211 Receives reassigned benefits from 6 practitioners
Practice locations: Daleville, VA; Salem, VA

National Provider Directory

National Provider Directory

Locations

115 Shenandoah Ave
Daleville, VA 24083
Phone (540) 591-5360

1620 Apperson Dr
Salem, VA 24153
Phone (540) 444-0291

401 Apperson Dr
Salem, VA 24153
Phone (540) 375-7200

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417478400000",
    "number": "1083623284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 APPERSON DR",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241537217",
            "telephone_number": "540-444-0291",
            "fax_number": "540-444-0293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 APPERSON DR",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241537217",
            "telephone_number": "540-444-0291",
            "fax_number": "540-444-0293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED PHYSICAL THERAPY OF VIRGINIA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-05",
        "last_updated": "2014-12-02",
        "status": "A",
        "authorized_official_last_name": "ELLEXSON",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "540-444-0291",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "230500588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.