NPIMap

Organization Active NPI

Mosher Physical Therapy & Sports Medicine PC

  • Physical Medicine & Rehabilitation Physician
  • Cape Charles, VA
National Provider Identifier
1194702936
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
5088 Issued in VA
Legal business name
MOSHER PHYSICAL THERAPY & SPORTS MEDICINE PC
Practice address
712 Randolph Ave
Cape Charles, VA 23310-3308
Phone
(757) 331-4490
Fax
(757) 331-4491
NPI assigned
Dec 22, 2005
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Russell A Mosher, MSPT
Title
President Owner
Phone
(757) 789-3075

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 5088 VA Primary

Addresses

Primary practice location

712 Randolph Ave
Cape Charles, VA 23310-3308

Mailing address

PO Box 1059
Onley, VA 23418-1059
Phone (757) 331-4490

Other identifiers 1

IdentifierTypeStateIssuer
147224OtherVAANTHEM BCBS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1194702936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1059",
            "city": "ONLEY",
            "state": "VA",
            "postal_code": "234181059",
            "telephone_number": "757-331-4490",
            "fax_number": "757-331-4491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712 RANDOLPH AVE",
            "city": "CAPE CHARLES",
            "state": "VA",
            "postal_code": "233103308",
            "telephone_number": "757-331-4490",
            "fax_number": "757-331-4491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOSHER PHYSICAL THERAPY & SPORTS MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MOSHER",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "757-789-3075",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSPT"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "VA",
            "license": "5088",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "147224",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Charles, 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.

Verify at the official NPI Registry.