Individual provider Active NPI

Ginnie Ileto

  • Physical Therapist
  • Chesapeake, VA
National Provider Identifier
1265723233
Registry record updated Apr 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305206851 Issued in VA
Practice address
516 Innovation Dr Ste 100
Chesapeake, VA 23320-3868
Phone
(757) 842-6562
NPI assigned
Apr 26, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2305206851 VA Primary
Physical Therapist 225100000X 37437 CA

Addresses

Primary practice location

516 Innovation Dr Ste 100
Chesapeake, VA 23320-3868

Mailing address

516 Innovation Drive, Suite 100
Chesapeake, VA 23320

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
37437CAMDDentist
2305206851VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Jrose Integrative Therapy PastSince May 9, 2008 Accepting new patients
Restorative Physical Therapy & Wellness LLC PastSince Oct 13, 2015 Accepting new patients

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": "1303776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303776000000",
    "number": "1265723233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 INNOVATION DRIVE, SUITE 100",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "23320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 INNOVATION DR STE 100",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233203868",
            "telephone_number": "757-842-6562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ILETO",
        "first_name": "GINNIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-26",
        "last_updated": "2011-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305206851",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "37437",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesapeake, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2011; 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.