NPIMap

Organization Active NPI

Ivyrehab Sept, LLC

  • Physical Therapist
  • Virginia Beach, VA
National Provider Identifier
1235356155
Registry record updated Nov 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
IVYREHAB SEPT, LLC
Practice address
1157 First Colonial Rd
Sute 201
Virginia Beach, VA 23454-2432
Phone
(757) 481-0052
Fax
(757) 481-1099
NPI assigned
Apr 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2017

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

Authorized official

Name
Mr. Kenneth Miles
Title
Evp & Cfo
Phone
(631) 580-5200

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X

Addresses

Primary practice location

1157 First Colonial Rd
Sute 201
Virginia Beach, VA 23454-2432

Mailing address

5301 Providence Rd
Suite 80
Virginia Beach, VA 23464-4128
Phone (757) 467-1900

National Provider Directory

National Provider Directory
Tax ID family
Southeastern Physical T19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

Organizations that report the same tax identification number in the National Provider Directory.

View all 18

Locations

1157 First Colonial Rd
Ste 201
Virginia Beach, VA 23454
Phone (757) 481-0052

NPI Registry JSON

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1511136000000",
    "number": "1235356155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5301 PROVIDENCE RD",
            "address_2": "SUITE 80",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234644128",
            "telephone_number": "757-467-1900",
            "fax_number": "757-467-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1157 FIRST COLONIAL RD",
            "address_2": "SUTE 201",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234542432",
            "telephone_number": "757-481-0052",
            "fax_number": "757-481-1099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IVYREHAB SEPT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-20",
        "last_updated": "2017-11-20",
        "status": "A",
        "authorized_official_last_name": "MILES",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "EVP & CFO",
        "authorized_official_telephone_number": "631-580-5200",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 Nov 20, 2017; 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.