Individual provider Active NPI

Anna N Clemmer, DPT

  • Physical Therapist
  • Virginia Beach, VA
National Provider Identifier
1356015069
Registry record updated Jan 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305214547 Issued in VA
Practice address
5604 Virginia Beach Blvd Ste 101
Virginia Beach, VA 23462-5631
Phone
(757) 455-5000
Fax
(757) 319-4142
NPI assigned
Aug 5, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2305214547 VA Primary

Addresses

Primary practice location

5604 Virginia Beach Blvd Ste 101
Virginia Beach, VA 23462-5631

Mailing address

5009 Amboy CT
Virginia Beach, VA 23462-4233
Phone (540) 272-0803

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210922002145 VA Practitioner - Physical Therapist in Private Practice 2466859137 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
JP Therapy LLCGroup PAC ID 6709192503, 28 clinicians

Practice addresses (Care Compare)

5604 Virginia Beach Blvd
Suite 101
Virginia Beach, VA 23462-5631
Phone (757) 455-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
JP Therapy, LLC CurrentSince Sep 11, 2023 Accepting new patients

Locations

5604 Virginia Beach Blvd
Ste 101
Virginia Beach, VA 23462

Organizations & group practices 1

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": "1628121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705449600000",
    "number": "1356015069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5009 AMBOY CT",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234624233",
            "telephone_number": "540-272-0803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5604 VIRGINIA BEACH BLVD STE 101",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234625631",
            "telephone_number": "757-455-5000",
            "fax_number": "757-319-4142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMMER",
        "first_name": "ANNA",
        "middle_name": "N",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-05",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305214547",
            "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 Jan 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.