Virginia Stalnaker, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PTL27997 Issued in MA

Practice address

470 W Broadway Ste 2
South Boston, MA 02127-2260

Phone

(617) 752-4643

NPI assigned

Oct 14, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Temple University School of Medicine, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bay State Physical Therapy of Randolph IncGroup PAC ID 6305744251, 451 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Bay State Physical Therapy of Randolph Inc

  • Physical Therapist
  • Fall River, MA
  • NPI 1164474334
  Medicare reassignment Care Compare group NPD
• Bay State Physical Therapy of Randolph Inc

  • Physical Therapist
  • Franklin, MA
  • NPI 1821108549
  NPD

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

{
    "created_epoch": "1728864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728864000000",
    "number": "1386464410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 GRANITE ST STE 3",
            "city": "BRAINTREE",
            "state": "MA",
            "postal_code": "021845350",
            "telephone_number": "781-807-6138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "470 W BROADWAY STE 2",
            "city": "SOUTH BOSTON",
            "state": "MA",
            "postal_code": "021272260",
            "telephone_number": "617-752-4643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STALNAKER",
        "first_name": "VIRGINIA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-14",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "PTL27997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• South Boston Community Health Center
• South Boston Dental Associates
• South Boston Family Dental LLC
• South Boston Nursing LLC
• Rachel Souza, DO
• Sophia Kay Struzziero
• Alexandra Sullivan
• Amanda Marie Sullivan, RN
• Daniel T Sullivan, LICSW
• Brianna Nicole Sutherland

• Physical Therapist in South Boston, MA
• Providers in South Boston, MA by specialty
• Physical Therapist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 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.