Individual provider Active NPI

Michele Christine Nielsen, DPT

  • Physical Therapist
  • Virginia Beach, VA
National Provider Identifier
1366537219
Registry record updated Mar 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305204696 Issued in VA
Practice address
2126 Great Neck SQ
Virginia Beach, VA 23454-2202
Phone
(757) 578-2197
Fax
(757) 578-2330
NPI assigned
Oct 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2025

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 2305204696 VA Primary

Addresses

Primary practice location

2126 Great Neck SQ
Virginia Beach, VA 23454-2202

Mailing address

2126 Great Neck SQ
Virginia Beach, VA 23454-2202
Phone (757) 578-2197

Other identifiers 4

IdentifierTypeStateIssuer
541853904OtherVACOMMERCIAL
541853904OtherVAAETNA
1366537219OtherMEDICARE RAILROAD
192612OtherVAANTHEM

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070625000524 VA Practitioner - Physical Therapist in Private Practice 1355440868 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Virginia Beach Physical Therapy and Wellness , PLLCGroup PAC ID 0840584439, 4 clinicians

Practice addresses (Care Compare)

2126 Great Neck SQ
Virginia Beach, VA 23454-2202
Phone (757) 714-6058

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2305204696VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Virginia Beach Physical Therapy & Wellness , PLLC Physical Therapist CurrentSince May 18, 2016 Accepting new patients

Locations

2126 Great Neck Sq
Virginia Beach, VA 23454
Phone (757) 578-2197

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742860800000",
    "number": "1366537219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2126 GREAT NECK SQ",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234542202",
            "telephone_number": "757-578-2197",
            "fax_number": "757-578-2330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2126 GREAT NECK SQ",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234542202",
            "telephone_number": "757-578-2197",
            "fax_number": "757-578-2330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIELSEN",
        "first_name": "MICHELE",
        "middle_name": "CHRISTINE",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305204696",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL",
            "identifier": "541853904",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "541853904",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "1366537219",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "192612",
            "state": "VA"
        }
    ],
    "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 Mar 25, 2025; 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.