Organization Active NPI

Fedserve Hampton Roads

  • Physical Therapy Assistant
  • Norfolk, VA
National Provider Identifier
1174473433
Registry record updated Jan 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
Legal business name
FEDSERVE HAMPTON ROADS
Practice address
901 Hampton Blvd Ste 302
Norfolk, VA 23507-1503
Phone
(301) 841-5077
NPI assigned
Jan 28, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2026

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

Authorized official

Name
Daniel Odukoya
Title
Owner
Phone
(301) 841-5077

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 225200000X Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Physical Therapy Clinic/Center 261QP2000X

Addresses

Primary practice location

901 Hampton Blvd Ste 302
Norfolk, VA 23507-1503

Mailing address

4789 Cherokee St
College Park, MD 20740-1816
Phone (301) 841-5077

National Provider Directory

National Provider Directory

Practitioners & 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": "1769558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769558400000",
    "number": "1174473433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4789 CHEROKEE ST",
            "city": "COLLEGE PARK",
            "state": "MD",
            "postal_code": "207401816",
            "telephone_number": "301-841-5077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 HAMPTON BLVD STE 302",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071503",
            "telephone_number": "301-841-5077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FEDSERVE HAMPTON ROADS",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-28",
        "last_updated": "2026-01-28",
        "certification_date": "2026-01-28",
        "status": "A",
        "authorized_official_last_name": "ODUKOYA",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-841-5077"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2026; 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.