Individual provider Active NPI

Karen Worth Royall, DPT

  • Physical Therapist
  • Virginia Beach, VA
National Provider Identifier
1265455570
Registry record updated Aug 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305002708 Issued in VA
Practice address
1400 Fordham Dr
Virginia Beach, VA 23464-5368
Phone
(757) 361-3951
Fax
(757) 361-3957
NPI assigned
Jul 26, 2006
Last updated
Aug 15, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2014

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 2305002708 VA Primary

Addresses

Primary practice location

1400 Fordham Dr
Virginia Beach, VA 23464-5368

Mailing address

218 51St St
Virginia Beach, VA 23451-2428
Phone (757) 647-5107

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140814002729 VA Practitioner - Physical Therapist in Private Practice 9335366319 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2305002708VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Old Dominion University Physical Therapist CurrentSince May 1, 2014 Accepting new patients

Organizations & group practices 1

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408060800000",
    "number": "1265455570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 51ST ST",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234512428",
            "telephone_number": "757-647-5107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 FORDHAM DR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234645368",
            "telephone_number": "757-361-3951",
            "fax_number": "757-361-3957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROYALL",
        "first_name": "KAREN",
        "middle_name": "WORTH",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2014-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305002708",
            "primary": true
        }
    ],
    "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 Aug 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.