Active NPI
Adam Michael Ksanznak, DPT
- Physical Therapist
- Norfolk, VA
National Provider Identifier
1295332005
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2305213848
- Practice address
- 5900 E Virginia Beach Blvd Ste 21
Norfolk, VA 23502-2499 - Phone
- (757) 995-1903
- NPI assigned
- Oct 5, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2305213848 | VA | Primary |
Addresses
Primary practice location
5900 E Virginia Beach Blvd Ste 21
Norfolk, VA 23502-2499
Mailing address
PO Box 744113
Atlanta, GA 30384-4113
Phone (703) 239-2300
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2305213848 | VA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1601856000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621468800000",
"number": "1295332005",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 744113",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303844113",
"telephone_number": "703-239-2300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5900 E VIRGINIA BEACH BLVD STE 21",
"city": "NORFOLK",
"state": "VA",
"postal_code": "235022499",
"telephone_number": "757-995-1903"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KSANZNAK",
"first_name": "ADAM",
"middle_name": "MICHAEL",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-10-05",
"last_updated": "2021-05-20",
"certification_date": "2021-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "VA",
"license": "2305213848",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Norfolk, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 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.