Active NPI
Autumn Gray Hottle
- Physical Therapy Assistant
- Virginia Beach, VA
National Provider Identifier
1326820523
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 2306606428
- Practice address
- 1120 First Colonial Rd
Virginia Beach, VA 23454-2418 - Phone
- (757) 455-5000
- NPI assigned
- Oct 20, 2023
- Sex
- Female
- 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 Therapy Assistant | 225200000X | 2306606428 | VA | Primary |
Addresses
Primary practice location
1120 First Colonial Rd
Virginia Beach, VA 23454-2418
Mailing address
1761 Brucetown Rd
Clear Brook, VA 22624-1114
Phone (540) 398-9445
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 |
|---|---|---|---|
| 2306606428 | VA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1697760000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697760000000",
"number": "1326820523",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1761 BRUCETOWN RD",
"city": "CLEAR BROOK",
"state": "VA",
"postal_code": "226241114",
"telephone_number": "540-398-9445"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1120 FIRST COLONIAL RD",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234542418",
"telephone_number": "757-455-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOTTLE",
"first_name": "AUTUMN",
"middle_name": "GRAY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-10-20",
"last_updated": "2023-10-20",
"certification_date": "2023-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "VA",
"license": "2306606428",
"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 Oct 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.