Michelle M Banazwski, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2305207290 Issued in VA

Practice address

1309 Kempsville Rd
Norfolk, VA 23502-2205

Phone

(757) 461-5001

NPI assigned

Feb 17, 2006

Last updated

Jan 8, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Michelle Miller Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Proactive Therapy of South Carolina Inc

  dba Select Physical Therapy

  • Rehabilitation Clinic/Center
  • Mount Pleasant, SC
  • NPI 1164057048

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767830400000",
    "number": "1255305983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 LE COVE CT",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234641652",
            "telephone_number": "843-693-1747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1309 KEMPSVILLE RD",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235022205",
            "telephone_number": "757-461-5001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANAZWSKI",
        "first_name": "MICHELLE",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-17",
        "last_updated": "2026-01-08",
        "certification_date": "2026-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305207290",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "4619",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "MILLER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Balm of Gilead Counseling Services (Pisteuo counseling)
• Leigh Baltuch, M.D.
• Heather Bamford, CPNP-AC
• Shanley Banaag, D.O.
• Julie Banaszak, ATC
• Ilian Bandaranayake, M.D.
• Agnes Bautista Banias, RDH
• Alan Kirk Banks, MD
• Destini Banks
• Nicole Kay Banks, MD

• Physical Therapist in Norfolk, VA
• Providers in Norfolk, VA by specialty
• Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2026; 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.