Active NPI
Wendy B Jaffe, PT, PLLC
- Pediatric Physical Therapist
- Virginia Beach, VA
National Provider Identifier
1124154471
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- 2305005698
- Legal business name
- WENDY B JAFFE, PT, PLLC
- Practice address
- 2525 Inlynnview Rd
Virginia Beach, VA 23454-1846 - Phone
- (757) 268-2604
- NPI assigned
- Feb 23, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Wendy B Jaffe
- Title
- Owner
- Phone
- (757) 268-2604
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | 2305005698 | VA | Primary |
Addresses
Primary practice location
2525 Inlynnview Rd
Virginia Beach, VA 23454-1846
Mailing address
2525 Inlynnview Rd
Virginia Beach, VA 23454-1846
Phone (757) 268-2604
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 195322 | Other | VA | SOUTHEAST SERVICES, INC. |
| 452542 | Other | VA | ANTHEM BC BS |
Other names 1
- Pediatric Evaluation and Developmental Services
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172188800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1124154471",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2525 INLYNNVIEW RD",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234541846",
"telephone_number": "757-268-2604"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2525 INLYNNVIEW RD",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234541846",
"telephone_number": "757-268-2604"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WENDY B JAFFE, PT, PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2007-02-23",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "JAFFE",
"authorized_official_first_name": "WENDY",
"authorized_official_middle_name": "B",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "757-268-2604"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Therapist, Pediatrics",
"state": "VA",
"license": "2305005698",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SOUTHEAST SERVICES, INC.",
"identifier": "195322",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BC BS",
"identifier": "452542",
"state": "VA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Pediatric Evaluation and Developmental Services",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Virginia Beach, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.