Organization Active NPI

Back to Basics Family Physical Therapy PC

  • Physical Medicine & Rehabilitation Physician
  • Roanoke, VA
National Provider Identifier
1417998329
Registry record updated Jan 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
2305004995 Issued in VA
Legal business name
BACK TO BASICS FAMILY PHYSICAL THERAPY PC
Practice address
7768 Williamson Rd
Roanoke, VA 24019-4343
Phone
(540) 985-0500
Fax
(540) 985-0529
NPI assigned
Jun 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2026

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

Authorized official

Name
Jeffrey M Ford
Title
Business Manager
Phone
(540) 985-0500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X 2305004995 VA Primary

Addresses

Primary practice location

7768 Williamson Rd
Roanoke, VA 24019-4343

Mailing address

7768 Williamson Rd
Roanoke, VA 24019-4343
Phone (540) 985-0500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040603000887 VA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 3072595008 Receives reassigned benefits from 2 practitioners
Practice locations: Roanoke, VA

National Provider Directory

National Provider Directory

Locations

7768 Williamson Rd
Roanoke, VA 24019
Phone (540) 985-0500

1015 1st St SW
Ste 2
Roanoke, VA 24016
Phone (540) 985-0500

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/16094/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 8

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

NPI Registry JSON

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768176000000",
    "number": "1417998329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7768 WILLIAMSON RD",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240194343",
            "telephone_number": "540-985-0500",
            "fax_number": "540-985-0529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7768 WILLIAMSON RD",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240194343",
            "telephone_number": "540-985-0500",
            "fax_number": "540-985-0529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACK TO BASICS FAMILY PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-10",
        "last_updated": "2026-01-12",
        "certification_date": "2026-01-12",
        "status": "A",
        "authorized_official_last_name": "FORD",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "540-985-0500"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "VA",
            "license": "2305004995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.