Peninsula Physical Therapy & Associates, Inc

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

2305001701 Issued in VA

Legal business name

PENINSULA PHYSICAL THERAPY & ASSOCIATES, INC

Practice address

1618 Hardy Cash Dr
Hampton, VA 23666-2400

Phone

(757) 838-7453

Fax

(757) 838-2314

NPI assigned

Jan 26, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Angelo L Suggs, PTNPI 1689693533

Title

President / Ceo

Phone

(757) 838-7453

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Outpatient physical therapy / speech pathology certification: CCN 496644

Legal name

PENINSULA PHYSICAL THERAPY & ASSOCIATES INC

Certification status

Active

Provider type (POS)

Outpatient physical therapy / speech pathology

Participating since

Apr 1, 1997

Last certification

Jan 31, 2024

Ownership / control type

Proprietary

Most recent change of ownership

Aug 1, 2000

Facility address

1618 Hardy Cash Drive
Hampton, VA 23666

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John Vincent Klemer, PT

  • Physical Therapist
  • Williamsburg, VA
  • NPI 1447763701
  Medicare reassignment Care Compare group NPD
• Kwesi Azikiwe Smith, DPT

  • Physical Therapist
  • Hampton, VA
  • NPI 1316720279
  Medicare reassignment Care Compare group NPD
• Angelo L Suggs, PT

  • Physical Therapist
  • Hampton, VA
  • NPI 1689693533
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473120000000",
    "number": "1356311880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1618 HARDY CASH DR",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236662400",
            "telephone_number": "757-838-7453",
            "fax_number": "757-838-2314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1618 HARDY CASH DR",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236662400",
            "telephone_number": "757-838-7453",
            "fax_number": "757-838-2314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENINSULA PHYSICAL THERAPY & ASSOCIATES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-26",
        "last_updated": "2016-09-06",
        "status": "A",
        "authorized_official_last_name": "SUGGS",
        "authorized_official_first_name": "ANGELO",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT / CEO",
        "authorized_official_telephone_number": "757-838-7453",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "VA",
            "license": "2305001701",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4979397",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Peninsula Neurosurgical Associates, Inc.
• Peninsula Orthopaedic Group, PC
• Peninsula Orthopaedic Group, PC
• Peninsula Outreach Family Counseling LLC
• Peninsula Periodontics and Implants PLLC (Atlantic Periodontics & Implants)
• Peninsula Surgical Associates, Inc.
• Peninsula Vascular Center, P.C.
• Peninusla Emergency Physician
• Yanira Perez Rivera, DC
• Ariana Perez

• Physical Therapy Clinic/Center in Hampton, VA
• Providers in Hampton, VA by specialty
• Physical Therapy Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.