Individual provider Active NPI

Pamela O Tucker, PT DPT

  • Physical Therapist
  • Hampton, VA
National Provider Identifier
1093252900
Registry record updated Jan 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305204128 Issued in VA
Practice address
304 Marcella Rd
Ste E
Hampton, VA 23666
Phone
(757) 825-9446
Fax
(757) 825-9476
NPI assigned
Jan 30, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2017

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 2305204128 VA Primary

Addresses

Primary practice location

304 Marcella Rd
Ste E
Hampton, VA 23666

Mailing address

729 Thimble Shoals Blvd Ste
Ste 4-C
Newport News, VA 23606
Phone (757) 873-2932

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2305204128VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Dominion Physical Therapy & Associates Inc. Past Accepting new patients
Dominion Physical Therapy and Associates Incorporated Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/6016/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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": "1485734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485820800000",
    "number": "1093252900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "729 THIMBLE SHOALS BLVD STE",
            "address_2": "STE 4-C",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "23606",
            "telephone_number": "757-873-2932",
            "fax_number": "757-873-8780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 MARCELLA RD",
            "address_2": "STE E",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "23666",
            "telephone_number": "757-825-9446",
            "fax_number": "757-825-9476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "PAMELA",
        "middle_name": "O",
        "credential": "PT DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-30",
        "last_updated": "2017-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305204128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hampton, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2017; 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.