Churchland Physical Therapy Services, Inc

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2305000773 Issued in VA

Legal business name

CHURCHLAND PHYSICAL THERAPY SERVICES, INC

Practice address

5900 Churchland Blvd
Portsmouth, VA 23703-3313

Phone

(757) 483-0333

Fax

(757) 483-9359

NPI assigned

Jul 1, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Martin Boytek Jr., PHYSICAL THERAPIST

Title

President/Owner/Physical Therapist

Phone

(757) 483-0333

Specialties & licenses 1

Addresses

Other identifiers 7

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Terrilyn Etheridge, PHYSICAL THERAPIST

  • Physical Therapist
  • Portsmouth, VA
  • NPI 1366564999
  NPD (past)

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

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196294400000",
    "number": "1124057211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 CHURCHLAND BLVD",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237033313",
            "telephone_number": "757-483-0333",
            "fax_number": "757-483-9359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 CHURCHLAND BLVD",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237033313",
            "telephone_number": "757-483-0333",
            "fax_number": "757-483-9359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHURCHLAND PHYSICAL THERAPY SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-01",
        "last_updated": "2007-11-29",
        "status": "A",
        "authorized_official_last_name": "BOYTEK",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_title_or_position": "PRESIDENT/OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "757-483-0333",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "PHYSICAL THERAPIST"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305000773",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMA MEDICARE",
            "identifier": "200327",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MDIPA",
            "identifier": "325835",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS",
            "identifier": "191880",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MDIPA",
            "identifier": "371787",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MPN",
            "identifier": "808578",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "U.S.DEPT OF LABOR",
            "identifier": "150870400",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMA PPO",
            "identifier": "26207",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Raegan Alexandra Chunn, MD
• Thomas Markham Chupp, M.D.
• Tyler Church, D.O.
• Churchland Chiropractic
• Churchland Family Medicine PC
• Vincent A Ciarametaro, RPH
• Kyle Cichos
• David Alexander Cieremans, DO
• Cade Coleman Cinnamond, D.O.
• Brian Luke Ciszewski, MD

• Physical Therapist in Portsmouth, VA
• Providers in Portsmouth, VA by specialty
• Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 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.