Individual provider Active NPI

Gregory Stuart Syvertson, PT, DPT, CFT,CCI

  • Physical Therapist
  • Suffolk, VA
National Provider Identifier
1104800655
Registry record updated Mar 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305208561 Issued in VA
Practice address
5859 Harbour View Blvd Ste 100
Suffolk, VA 23435-3015
Phone
(757) 686-0205
Fax
(757) 686-0206
NPI assigned
Nov 29, 2005
Last updated
Mar 18, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2026

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 2305208561 VA Primary

Addresses

Primary practice location

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

Mailing address

5851 Harbour View Blvd.
Suite 100
Suffolk, VA 23435
Phone (757) 686-0205

Other names 1

  • Dr. Greg S Syvertson Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230814000247 VA Practitioner - Physical Therapist in Private Practice 9830009448 Reassigns benefits to 1 organization
Practice locations: Norfolk, VA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2305208561VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physiotherapy Associates, Inc. Physical Therapist Current Accepting new patients
Physiotherapy Assoicates, Inc. CurrentSince May 29, 2023 Accepting new patients
Physiotherapy Associates Inc CurrentSince May 29, 2023 Accepting new patients
Masterworks Inc Physical Therapist CurrentSince Mar 5, 2004 Accepting new patients
Marden Rehabilitation Associates of Portage County, Inc. Physical Therapist Past Accepting new patients

Locations

20925 Professional Plz
Ste 300
Ashburn, VA 20147
Phone (703) 544-7171

6160 Kempsville Cir
Ste 303A
Norfolk, VA 23502
Phone (757) 333-3360

5859 Harbour View Blvd
Ste 100
Suffolk, VA 23435
Phone (757) 686-0205

390 John Raine Dr
Rainelle, WV 25962
Phone (304) 438-9225

Organizations & group practices 5

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": "1133222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773792000000",
    "number": "1104800655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5851 HARBOUR VIEW BLVD.",
            "address_2": "SUITE 100",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "23435",
            "telephone_number": "757-686-0205",
            "fax_number": "757-686-0206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5859 HARBOUR VIEW BLVD STE 100",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234353015",
            "telephone_number": "757-686-0205",
            "fax_number": "757-686-0206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SYVERTSON",
        "first_name": "GREGORY",
        "middle_name": "STUART",
        "name_prefix": "Dr.",
        "credential": "PT, DPT, CFT,CCI",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-29",
        "last_updated": "2026-03-18",
        "certification_date": "2026-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305208561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GREG",
            "last_name": "SYVERTSON",
            "middle_name": "S",
            "prefix": "DR.",
            "credential": "PT, DPT, CFT,CCI",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Mar 18, 2026; 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.