Active NPI
Nicole B Sandridge, DPT
- Physical Therapist
- Chester, VA
National Provider Identifier
1205114105
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2305206997
- Practice address
- 13048 Rivers Bend Rd
Chester, VA 23836-2564 - Phone
- (804) 523-0333
- Fax
- (804) 530-9998
- NPI assigned
- Jul 26, 2011
- Last updated
- Dec 30, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2305206997 | VA | Primary |
Addresses
Primary practice location
13048 Rivers Bend Rd
Chester, VA 23836-2564
Mailing address
13000 Rivers Bend Blvd
Ste D
Chester, VA 23836-8632
Phone (804) 571-5106
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2305206997 | VA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1311638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1483056000000",
"number": "1205114105",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13000 RIVERS BEND BLVD",
"address_2": "STE D",
"city": "CHESTER",
"state": "VA",
"postal_code": "238368632",
"telephone_number": "804-571-5106",
"fax_number": "804-530-1857"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13048 RIVERS BEND RD",
"city": "CHESTER",
"state": "VA",
"postal_code": "238362564",
"telephone_number": "804-523-0333",
"fax_number": "804-530-9998"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANDRIDGE",
"first_name": "NICOLE",
"middle_name": "B",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-07-26",
"last_updated": "2016-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "VA",
"license": "2305206997",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chester, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.