Individual provider Active NPI

Carolyn A Brown, PT

  • Physical Therapist
  • Virginia Beach, VA
National Provider Identifier
1093065468
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305004787 Issued in VA
Practice address
225 Clearfield Ave
Virginia Beach, VA 23462-1815
Phone
(757) 457-5100
Fax
(757) 961-3696
NPI assigned
Sep 13, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 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 2305004787 VA Primary

Addresses

Primary practice location

225 Clearfield Ave
Virginia Beach, VA 23462-1815

Mailing address

225 Clearfield Ave
Virginia Beach, VA 23462-1815
Phone (757) 457-5100

Other practice location 1

4000 Coliseum Dr Ste 300
Hampton, VA 23666-5974
Phone (757) 457-5100

Other practice location 2

3640 High St Ste 3B
Portsmouth, VA 23707-3213
Phone (757) 457-5100

Other practice location 3

2000 Meade Pkwy
Suffolk, VA 23434-4259
Phone (757) 934-9300

Other practice location 4

229 Clearfield Ave Ste 300
Virginia Beach, VA 23462-1815
Phone (757) 457-5177

Other identifiers 1

IdentifierTypeStateIssuer
1093065468MedicaidVA

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

NPI Registry JSON

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

{
    "created_epoch": "1347494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1093065468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 CLEARFIELD AVE",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234621815",
            "telephone_number": "757-457-5100",
            "fax_number": "757-961-3696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 CLEARFIELD AVE",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234621815",
            "telephone_number": "757-457-5100",
            "fax_number": "757-961-3696"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4000 Coliseum Dr Ste 300",
            "address_purpose": "LOCATION",
            "city": "Hampton",
            "state": "VA",
            "postal_code": "236665974",
            "country_code": "US",
            "telephone_number": "757-457-5100",
            "fax_number": "757-224-1799",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3640 High St Ste 3B",
            "address_purpose": "LOCATION",
            "city": "Portsmouth",
            "state": "VA",
            "postal_code": "237073213",
            "country_code": "US",
            "telephone_number": "757-457-5100",
            "fax_number": "757-452-3402",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2000 Meade Pkwy",
            "address_purpose": "LOCATION",
            "city": "Suffolk",
            "state": "VA",
            "postal_code": "234344259",
            "country_code": "US",
            "telephone_number": "757-934-9300",
            "fax_number": "757-961-3696",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "229 Clearfield Ave Ste 300",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234621815",
            "country_code": "US",
            "telephone_number": "757-457-5177",
            "fax_number": "757-452-3494",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "CAROLYN",
        "middle_name": "A",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-13",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305004787",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1093065468",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.