Individual provider Active NPI

Susan C Parks, PT

  • Physical Therapist
  • Virginia Beach, VA
National Provider Identifier
1427355478
Registry record updated Feb 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305004212 Issued in VA
Practice address
2224 Virginia Beach Blvd
Virginia Beach, VA 23454-4285
Phone
(757) 486-8663
NPI assigned
Feb 26, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2011

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 2305004212 VA Primary

Addresses

Primary practice location

2224 Virginia Beach Blvd
Virginia Beach, VA 23454-4285

Mailing address

806 Addison CT
Virginia Beach, VA 23462-6904
Phone (757) 486-8663

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110722000283 VA Practitioner - Physical Therapist in Private Practice 0446428270 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1986
Medicare assignment
May accept Medicare assignment
Group practices
Tracy M Hernandez IncGroup PAC ID 7214923598, 4 clinicians

Practice addresses (Care Compare)

2224 Virginia Beach Blvd
Suite 106
Virginia Beach, VA 23454-4285
Phone (757) 486-8663

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Tracy M. Hernandez, Inc. Physical Therapist CurrentSince Jul 14, 2011 Accepting new patients

Locations

2224 Virginia Beach Blvd
Ste 106
Virginia Beach, VA 23454
Phone (757) 486-8663

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": "1298678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298678400000",
    "number": "1427355478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "806 ADDISON CT",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234626904",
            "telephone_number": "757-486-8663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2224 VIRGINIA BEACH BLVD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234544285",
            "telephone_number": "757-486-8663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKS",
        "first_name": "SUSAN",
        "middle_name": "C",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-26",
        "last_updated": "2011-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305004212",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Feb 26, 2011; 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.