Active NPI
Crystal Michelle Larios
- Physical Therapy Assistant
- Virginia Beach, VA
National Provider Identifier
1407327729
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 2306602413
- Practice address
- Westminster Canterbury
Virginia Beach, VA 23451 - Phone
- (757) 496-1100
- NPI assigned
- Dec 14, 2018
- Last updated
- Dec 17, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 2306602413 | VA | Primary |
Addresses
Primary practice location
Westminster Canterbury
Virginia Beach, VA 23451
Mailing address
1421 Braden Cres
Norfolk, VA 23502-2108
Phone (757) 724-1407
Other practice location 1
1421 Braden Cres
Norfolk, VA 23502-2108
Phone (757) 724-1407
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1796563 | Other | VA | OPTIMA HEALTH |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2306602413 | VA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1544745600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1545004800000",
"number": "1407327729",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1421 BRADEN CRES",
"city": "NORFOLK",
"state": "VA",
"postal_code": "235022108",
"telephone_number": "757-724-1407"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "WESTMINSTER CANTERBURY",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "23451",
"telephone_number": "757-496-1100"
}
],
"practiceLocations": [
{
"address_1": "1421 Braden Cres",
"address_purpose": "LOCATION",
"city": "Norfolk",
"state": "VA",
"postal_code": "235022108",
"country_code": "US",
"telephone_number": "757-724-1407",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LARIOS",
"first_name": "CRYSTAL",
"middle_name": "MICHELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-12-14",
"last_updated": "2018-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "VA",
"license": "2306602413",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OPTIMA HEALTH",
"identifier": "1796563",
"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 Dec 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.