Active NPI
Mollie Krochmal, DPT
- Physical Therapist
- Chesapeake, VA
National Provider Identifier
1215549480
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 4016 Raintree Rd Ste 100a
Chesapeake, VA 23321-3700 - Phone
- (757) 488-2864
- NPI assigned
- Aug 19, 2020
- 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 | Primary |
Addresses
Primary practice location
4016 Raintree Rd Ste 100a
Chesapeake, VA 23321-3700
Mailing address
4016 Raintree Rd Ste 100a
Chesapeake, VA 23321-3700
Phone (757) 488-2864
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2305213797 | Other | VA | VIRGINIA DEPARTMENT OF HEALTH PROFESSIONAL |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jessica@tidewatertherapy.com | ||
| Direct Messaging Address | jessica@tidewatertherapy.com |
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597795200000",
"number": "1215549480",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4016 RAINTREE RD STE 100A",
"city": "CHESAPEAKE",
"state": "VA",
"postal_code": "233213700",
"telephone_number": "757-488-2864"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4016 RAINTREE RD STE 100A",
"city": "CHESAPEAKE",
"state": "VA",
"postal_code": "233213700",
"telephone_number": "757-488-2864"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KROCHMAL",
"first_name": "MOLLIE",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-08-19",
"last_updated": "2020-08-19",
"certification_date": "2020-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VIRGINIA DEPARTMENT OF HEALTH PROFESSIONAL",
"identifier": "2305213797",
"state": "VA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jessica@tidewatertherapy.com",
"affiliation": "N",
"address_1": "4016 Raintree Rd Ste 100A",
"city": "Chesapeake",
"state": "VA",
"country_code": "US",
"postal_code": "233213700",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jessica@tidewatertherapy.com",
"affiliation": "N",
"address_1": "4016 Raintree Rd Ste 100A",
"city": "Chesapeake",
"state": "VA",
"country_code": "US",
"postal_code": "233213700",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Chesapeake, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 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.