Individual provider Active NPI

Jennifer M Hyde, MSPT

  • Physical Therapist
  • Mechanicsville, VA
National Provider Identifier
1124199260
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305202826 Issued in VA
Practice address
9097 Atlee Station Rd
Suite 303
Mechanicsville, VA 23116-2525
Phone
(804) 559-3390
Fax
(804) 559-3514
NPI assigned
Nov 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 2305202826 VA Primary

Addresses

Primary practice location

9097 Atlee Station Rd
Suite 303
Mechanicsville, VA 23116-2525

Mailing address

10328 Berkeley Manor Dr
Mechanicsville, VA 23116-5132
Phone (804) 550-0971

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100106000868 VA Practitioner - Physical Therapist in Private Practice 0749320885 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Performance Physical Therapy and Sports Training, LLCGroup PAC ID 8022158161, 3 clinicians

Practice addresses (Care Compare)

9130 Dickey Dr
Mechanicsville, VA 23116-2502
Phone (804) 723-5940

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Performance Physical Therapy and Sports Training, LLC Physical Therapist CurrentSince Aug 6, 2009 Accepting new patients

Locations

9130 Dickey Dr
Mechanicsvlle, VA 23116
Phone (804) 723-5940

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": "1163289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124199260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10328 BERKELEY MANOR DR",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "231165132",
            "telephone_number": "804-550-0971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9097 ATLEE STATION RD",
            "address_2": "SUITE 303",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "231162525",
            "telephone_number": "804-559-3390",
            "fax_number": "804-559-3514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HYDE",
        "first_name": "JENNIFER",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305202826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mechanicsville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.