Individual provider Active NPI

Frida A Siller

  • Physical Therapy Assistant
  • Newport News, VA
National Provider Identifier
1356049845
Registry record updated Feb 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2306605900 Issued in VA
Practice address
11015 Warwick Blvd
Newport News, VA 23601-3225
Phone
(757) 595-9515
NPI assigned
Feb 23, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Exercise & Sports Psychologist 103TE1100X 2306605900 VA
Physical Therapy Assistant 225200000X 2306605900 VA Primary

Addresses

Primary practice location

11015 Warwick Blvd
Newport News, VA 23601-3225

Mailing address

1403 Oakdale Ave
Petersburg, VA 23803-3914
Phone (804) 585-7624

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

LicenseStateTypeSpecialty
2306605900VAMDExercise & Sports Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1677110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677110400000",
    "number": "1356049845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1403 OAKDALE AVE",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238033914",
            "telephone_number": "804-585-7624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11015 WARWICK BLVD",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236013225",
            "telephone_number": "757-595-9515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SILLER",
        "first_name": "FRIDA",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-23",
        "last_updated": "2023-02-23",
        "certification_date": "2023-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TE1100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Exercise & Sports",
            "state": "VA",
            "license": "2306605900",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "VA",
            "license": "2306605900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 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.

Verify at the official NPI Registry.