Individual provider Active NPI

Blair Tyson Thomasson, D.P.T

  • Physical Therapist
  • Suffolk, VA
National Provider Identifier
1104024876
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305205064 Issued in VA
Practice address
5859 Harbour View Blvd
Suite 100
Suffolk, VA 23435-3015
Phone
(757) 686-0205
NPI assigned
Jul 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 2305205064 VA Primary

Addresses

Primary practice location

5859 Harbour View Blvd
Suite 100
Suffolk, VA 23435-3015

Mailing address

112 Horse Run Dr
Chesapeake, VA 23322-5323

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
2305205064VAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1183507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104024876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 HORSE RUN DR",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233225323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5859 HARBOUR VIEW BLVD",
            "address_2": "SUITE 100",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234353015",
            "telephone_number": "757-686-0205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMASSON",
        "first_name": "BLAIR",
        "middle_name": "TYSON",
        "name_prefix": "Dr.",
        "credential": "D.P.T",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305205064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.