Individual provider Active NPI

Wendy Benton, P.T.

  • Physical Therapist
  • Chesapeake, VA
National Provider Identifier
1083884498
Registry record updated Jun 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305214303 Issued in VA
Practice address
436 Flintlock Rd
Chesapeake, VA 23322-5480
Phone
(443) 745-2392
NPI assigned
Mar 3, 2008
Last updated
Jun 13, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 296561 CA
Physical Therapist 225100000X 22469 MD
Physical Therapist 225100000X 2305214303 VA Primary

Addresses

Primary practice location

436 Flintlock Rd
Chesapeake, VA 23322-5480

Mailing address

436 Flintlock Rd
Chesapeake, VA 23322-5480
Phone (443) 745-2392

Other practice location 1

7505 Greenway Center Dr
301
Greenbelt, MD 20770-3507
Phone (301) 474-6505

Other practice location 2

4960 Verdugo Way
Camarillo, CA 93012-8632
Phone (805) 384-8050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20191106000934 CA Practitioner - Physical Therapist in Private Practice 2567794829 Reassigns benefits to 1 organization
I20210723000612 VA Practitioner - Physical Therapist in Private Practice 2567794829 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
296561CAMDPhysical Therapist
22469MDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Two Trees Physical Therapy & Wellness Inc Physical Therapist CurrentSince Sep 30, 2019 Accepting new patients
Virginia Luna Care Physical Therapy LLC Physical Therapist CurrentSince Nov 5, 2024 Accepting new patients
Two Trees Physical Therapy & Wellness Inc Physical Therapist CurrentSince Sep 30, 2019 Accepting new patients
Strong and Steady Physical Therapy and Wellness, LLC Physical Therapist CurrentSince Jul 6, 2021 Accepting new patients

Locations

4960 Verdugo Way
Camarillo, CA 93012
Phone (805) 222-4731

2100 Solar Dr
Ste 204
Oxnard, CA 93036
Phone (805) 222-6563

3418 Loma Vista Rd
Ste A
Ventura, CA 93003
Phone (805) 642-8565

8280 Willow Oaks Corporate Dr
Ste 600
Fairfax, VA 22031
Phone (202) 794-7159

4870 Sadler Rd
Ste 300
Glen Allen, VA 23060
Phone (757) 524-2304

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1204502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623542400000",
    "number": "1083884498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "436 FLINTLOCK RD",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233225480",
            "telephone_number": "443-745-2392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "436 FLINTLOCK RD",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233225480",
            "telephone_number": "443-745-2392"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7505 Greenway Center Dr",
            "address_2": "301",
            "address_purpose": "LOCATION",
            "city": "Greenbelt",
            "state": "MD",
            "postal_code": "207703507",
            "country_code": "US",
            "telephone_number": "301-474-6505",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4960 Verdugo Way",
            "address_purpose": "LOCATION",
            "city": "Camarillo",
            "state": "CA",
            "postal_code": "930128632",
            "country_code": "US",
            "telephone_number": "805-384-8050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENTON",
        "first_name": "WENDY",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-03",
        "last_updated": "2021-06-13",
        "certification_date": "2021-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "296561",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "22469",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305214303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesapeake, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2021; 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.