Brian Van Valkenburg, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

6535 Issued in TN

Practice address

3131 Tom Austin Hwy
Springfield, TN 37172-4801

Phone

(615) 382-7979

NPI assigned

Sep 24, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1506211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506211200000",
    "number": "1316456296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 BRIARCLIFF AVE APT C16",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378308787",
            "telephone_number": "941-266-9219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3131 TOM AUSTIN HWY",
            "city": "SPRINGFIELD",
            "state": "TN",
            "postal_code": "371724801",
            "telephone_number": "615-382-7979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN VALKENBURG",
        "first_name": "BRIAN",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-09-24",
        "last_updated": "2017-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TN",
            "license": "6535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Assistant in Springfield, TN
• Providers in Springfield, TN by specialty
• Physical Therapy Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2017; 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.