Individual provider Active NPI

Rachel Thacker, DPT

  • Physical Therapist
  • Virginia Beach, VA
National Provider Identifier
1184979015
Registry record updated Sep 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1231322 Issued in TX
Practice address
2135 General Booth Blvd
152
Virginia Beach, VA 23454-5881
Phone
(757) 430-8828
Fax
(757) 430-8189
NPI assigned
Jul 17, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2305207519 VA
Physical Therapist 225100000X 1231322 TX Primary

Addresses

Primary practice location

2135 General Booth Blvd
152
Virginia Beach, VA 23454-5881

Mailing address

2135 General Booth Blvd
152
Virginia Beach, VA 23454-5881
Phone (757) 430-8828

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2305207519VAMDPhysical Therapist
1231322TXMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Action Therapy Centers Limited Past Accepting new patients
Star Therapy Centers Limited Partnership Physical Therapist Past Accepting new patients

Organizations & group practices 2

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": "1342483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379462400000",
    "number": "1184979015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2135 GENERAL BOOTH BLVD",
            "address_2": "152",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234545881",
            "telephone_number": "757-430-8828",
            "fax_number": "757-430-8189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2135 GENERAL BOOTH BLVD",
            "address_2": "152",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234545881",
            "telephone_number": "757-430-8828",
            "fax_number": "757-430-8189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THACKER",
        "first_name": "RACHEL",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-17",
        "last_updated": "2013-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305207519",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1231322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Sep 18, 2013; 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.