Individual provider Active NPI

Jordan Molstre

  • Physical Therapist
  • Appomattox, VA
National Provider Identifier
1114473410
Registry record updated Aug 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305210469 Issued in VA
Practice address
571 Court Street
Appomattox, VA 24522
Phone
(434) 845-9053
NPI assigned
Aug 28, 2016
Last updated
Aug 28, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2016

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 2305210469 VA Primary

Addresses

Primary practice location

571 Court Street
Appomattox, VA 24522

Mailing address

20347 Timberlake Rd Ste B
Lynchburg, VA 24502-7352
Phone (434) 845-9053

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161004000973 VA Practitioner - Physical Therapist in Private Practice 0042508269 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

571 Court St
Appomattox, VA 24522-8212
Phone (737) 352-5799

Merit-based Incentive Payment System (MIPS)

Final score
91.57 of 100Reported as group
Quality
98.54
Improvement activities
40
Cost
74.59

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2305210469VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rehabilitation Associates of Central Virginia Limited Partnership Physical Therapist CurrentSince Dec 1, 2016 Accepting new patients
Rehabilitation Associates of Central Virginia Limited Partnership Physical Therapist CurrentSince Dec 1, 2016 Accepting new patients

Locations

1111 Corporate Park Dr
#B
Forest, VA 24551
Phone (434) 525-4851

1111 Corporate Park Dr
Ste B
Forest, VA 24551
Phone (434) 525-4851

20347 Timberlake Rd
Ste B
Lynchburg, VA 24502
Phone (434) 237-6812

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, 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": "1472342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472342400000",
    "number": "1114473410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20347 TIMBERLAKE RD STE B",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245027352",
            "telephone_number": "434-845-9053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "571 COURT STREET",
            "city": "APPOMATTOX",
            "state": "VA",
            "postal_code": "24522",
            "telephone_number": "434-845-9053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLSTRE",
        "first_name": "JORDAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-28",
        "last_updated": "2016-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305210469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Appomattox, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.