Individual provider Active NPI

Michelle Douglas, PT

  • Physical Therapist
  • Chesapeake, VA
National Provider Identifier
1114933587
Registry record updated Mar 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305005425 Issued in VA
Practice address
676 Battlefield Blvd N Ste C
Chesapeake, VA 23320-0306
Phone
(757) 436-2695
Fax
(757) 436-2697
NPI assigned
Jul 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2020

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 2305005425 VA Primary

Addresses

Primary practice location

676 Battlefield Blvd N Ste C
Chesapeake, VA 23320-0306

Mailing address

676 Battlefield Blvd N Ste C
Chesapeake, VA 23320-0306
Phone (757) 436-2695

Other names 1

  • Catherine Douglas Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061206000295 VA Practitioner - Physical Therapist in Private Practice 3577562248 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healing Hands Physical Therapy IncGroup PAC ID 6305845074, 2 clinicians

Practice addresses (Care Compare)

676 Battlefield Blvd N
Suite C
Chesapeake, VA 23320-0306
Phone (757) 436-2695

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2305005425VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Healing Hands Physical Therapy, Inc. Physical Therapist CurrentSince Sep 1, 2006 Accepting new patients

Locations

676 Battlefield Blvd N
Ste C
Chesapeake, VA 23320
Phone (757) 436-2695

612 Kingsborough Sq
Ste 203
Chesapeake, VA 23320

Organizations & group practices 1

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": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584576000000",
    "number": "1114933587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "676 BATTLEFIELD BLVD N STE C",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233200306",
            "telephone_number": "757-436-2695",
            "fax_number": "757-436-2697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "676 BATTLEFIELD BLVD N STE C",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233200306",
            "telephone_number": "757-436-2695",
            "fax_number": "757-436-2697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "MICHELLE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2020-03-19",
        "certification_date": "2020-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305005425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CATHERINE",
            "last_name": "DOUGLAS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chesapeake, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2020; 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.