Individual provider Active NPI

Rebecca Ann Erlich, DPT

  • Physical Therapist
  • Newport News, VA
National Provider Identifier
1245312859
Registry record updated Apr 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305204763 Issued in VA
Practice address
12655 Warwick Blvd
Ste B
Newport News, VA 23606
Phone
(757) 599-5551
Fax
(757) 595-5238
NPI assigned
Oct 20, 2006
Last updated
Apr 3, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2012

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 2305204763 VA Primary

Addresses

Primary practice location

12655 Warwick Blvd
Ste B
Newport News, VA 23606

Mailing address

860 Omni Blvd
Suite 303
Newport News, VA 23606-4430
Phone (757) 232-8769

Other identifiers 3

IdentifierTypeStateIssuer
010301416MedicaidVA
192965OtherVABCBS PHYSICAL THERAPY
7847829OtherVAAETNA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080306000108 VA Practitioner - Physical Therapist in Private Practice 1850476524 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

860 Omni Blvd
Newport News, VA 23606-4430

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Tidewater Physicians Multispecialty Group PC CurrentSince Jul 25, 2011 Accepting new patients
Tidewater Physicians Multispecialty Group PC CurrentSince Jul 25, 2011 Accepting new patients

Locations

12655 Warwick Blvd
#B
Newport News, VA 23606
Phone (757) 595-3570

729 Thimble Shoals Blvd
Newport News, VA 23606
Phone (757) 874-1077

827 Diligence Dr
Ste 100
Newport News, VA 23606

860 Omni Blvd
Ste 105
Newport News, VA 23606
Phone (757) 873-0952

860 Omni Blvd
Ste 303
Newport News, VA 23606
Phone (757) 232-8777

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333411200000",
    "number": "1245312859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 OMNI BLVD",
            "address_2": "SUITE 303",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064430",
            "telephone_number": "757-232-8769",
            "fax_number": "757-232-8875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12655 WARWICK BLVD",
            "address_2": "STE B",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "23606",
            "telephone_number": "757-599-5551",
            "fax_number": "757-595-5238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERLICH",
        "first_name": "REBECCA",
        "middle_name": "ANN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-20",
        "last_updated": "2012-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305204763",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010301416",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PHYSICAL THERAPY",
            "identifier": "192965",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7847829",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2012; 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.