Individual provider Active NPI

Mackenzie Hope Dumphy

  • Physical Therapist
  • Williamsburg, VA
National Provider Identifier
1235978172
Registry record updated May 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305216387
Practice address
5424 Discovery Park Boulevard
Building B, Suite 101
Williamsburg, VA 23188
Phone
(757) 345-2512
NPI assigned
May 21, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2305216387 Primary

Addresses

Primary practice location

5424 Discovery Park Boulevard
Building B, Suite 101
Williamsburg, VA 23188

Mailing address

307 Stonehouse Rd
Williamsburg, VA 23188-1208
Phone (757) 784-1635

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240904002284 VA Practitioner - Physical Therapist in Private Practice 9436699568 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tidewater Physicians Multispecialty Group, PCGroup PAC ID 2860398526, 259 clinicians

Practice addresses (Care Compare)

860 Omni Blvd
Suite 103
Newport News, VA 23606-4430
Phone (757) 345-2512

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Tidewater Physicians Multispecialty Group PC CurrentSince Jun 1, 2024 Accepting new patients
Tidewater Physicians Multispecialty Group PC CurrentSince Jun 1, 2024 Accepting new patients

Locations

860 Omni Blvd
Ste 401
Newport News, VA 23606
Phone (757) 232-8764

704 Thimble Shoals Blvd
#30
Newport News, VA 23606
Phone (757) 595-4300

860 Omni Blvd
Ste 103
Newport News, VA 23606
Phone (757) 223-9403

860 Omni Blvd
Newport News, VA 23606
Phone (757) 369-8138

827 Diligence Dr
Ste 100
Newport News, VA 23606

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BGFHDD

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.

NPI Registry JSON

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

{
    "created_epoch": "1716249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716249600000",
    "number": "1235978172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 STONEHOUSE RD",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231881208",
            "telephone_number": "757-784-1635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5424 DISCOVERY PARK BOULEVARD",
            "address_2": "BUILDING B, SUITE 101",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "23188",
            "telephone_number": "757-345-2512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUMPHY",
        "first_name": "MACKENZIE",
        "middle_name": "HOPE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-21",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": "2305216387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2024; 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.

Verify at the official NPI Registry.