Rise Physical Therapy & Wellness, PLLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

RISE PHYSICAL THERAPY & WELLNESS, PLLC

Practice address

15314 Carrollton Blvd
Carrollton, VA 23314-2304

Phone

(757) 650-2513

NPI assigned

Feb 16, 2021

Last updated

Feb 16, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jessica Rae Haynie, DPTNPI 1962702704

Title

Ceo/DPT

Phone

(757) 650-2513

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jessica R Haynie, DPT

  • Physical Therapist
  • Carrollton, VA
  • NPI 1962702704
  Authorized official Same address or phone

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

{
    "created_epoch": "1613433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613433600000",
    "number": "1295328706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9215 WIGNEIL ST",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234331530",
            "telephone_number": "757-650-2513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15314 CARROLLTON BLVD",
            "city": "CARROLLTON",
            "state": "VA",
            "postal_code": "233142304",
            "telephone_number": "757-650-2513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RISE PHYSICAL THERAPY & WELLNESS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-16",
        "last_updated": "2021-02-16",
        "certification_date": "2021-02-16",
        "status": "A",
        "authorized_official_last_name": "HAYNIE",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "RAE",
        "authorized_official_title_or_position": "CEO/DPT",
        "authorized_official_telephone_number": "757-650-2513",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Clinic/Center in Carrollton, VA
• Providers in Carrollton, VA by specialty
• Physical Therapy Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2021; 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.