Active NPI
Ethan Emmons, DPT
- Physical Therapist
- Virginia Beach, VA
National Provider Identifier
1194360180
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2305211904
- Practice address
- 984B Laskin Rd
Virginia Beach, VA 23451-3905 - Phone
- (757) 395-6900
- Fax
- (757) 425-7180
- NPI assigned
- Nov 13, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | |||
| Physical Therapist | 225100000X | 2305211904 | VA | Primary |
Addresses
Primary practice location
984B Laskin Rd
Virginia Beach, VA 23451-3905
Mailing address
907 Thousand Oaks Dr
Virginia Beach, VA 23454-3530
Phone (804) 627-2483
Other practice location 1
7419 Granby St
Norfolk, VA 23505-3406
Phone (757) 388-9910
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
984 B Laskin Rd
Virginia Beach, VA 23451-3905
Phone (757) 395-6900
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sentara Therapy Solutions, LLC | Physical Therapist | Current | Accepting new patients |
| Sentara Therapy Solutions, LLC | Physical Therapist | Current | Accepting new patients |
Locations
984B Laskin Rd
Virginia Beach, VA 23451
Phone (757) 395-6900
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.
-
- Physical Therapist
- Norfolk, VA
- NPI 1316590789
-
- Physical Therapist
- Virginia Beach, VA
- NPI 1972137032
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1573603200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616371200000",
"number": "1194360180",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "907 THOUSAND OAKS DR",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234543530",
"telephone_number": "804-627-2483"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "984B LASKIN RD",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234513905",
"telephone_number": "757-395-6900",
"fax_number": "757-425-7180"
}
],
"practiceLocations": [
{
"address_1": "7419 Granby St",
"address_purpose": "LOCATION",
"city": "Norfolk",
"state": "VA",
"postal_code": "235053406",
"country_code": "US",
"telephone_number": "757-388-9910",
"fax_number": "757-965-8551",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "EMMONS",
"first_name": "ETHAN",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-11-13",
"last_updated": "2021-03-22",
"certification_date": "2021-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": null,
"license": null,
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "VA",
"license": "2305211904",
"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 Mar 22, 2021; 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.