Divine Health and Wellness Corp

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

DIVINE HEALTH AND WELLNESS CORP

Doing business as

FYZICAL BonAir

Practice address

11412 Belvedere Vista LN
North Chesterfield, VA 23235-4392

Phone

(301) 980-4301

NPI assigned

May 9, 2023

Organization subpart

No

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

Authorized official

Name

Eileen Devine Salvi, MPTNPI 1154542736

Title

Physical Therapist/Owner

Phone

(301) 980-4301

Specialties & licenses 1

Addresses

Other names 1

• FYZICAL BonAir Doing business as

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Locations

Practitioners 2

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

• Eileen Devine Salvi, MPT

  • Physical Therapist
  • Williamsburg, VA
  • NPI 1154542736
  Medicare reassignment Care Compare group NPD Authorized official
• Samuel Reed Blair, PT

  • Physical Therapist
  • North Chesterfield, VA
  • NPI 1629897756
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1683590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691107200000",
    "number": "1427748995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 GEESE LNDG",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230605875",
            "telephone_number": "301-980-4301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11412 BELVEDERE VISTA LN",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232354392",
            "telephone_number": "301-980-4301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE HEALTH AND WELLNESS CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-09",
        "last_updated": "2023-08-04",
        "certification_date": "2023-08-04",
        "status": "A",
        "authorized_official_last_name": "SALVI",
        "authorized_official_first_name": "EILEEN",
        "authorized_official_middle_name": "DEVINE",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST/OWNER",
        "authorized_official_telephone_number": "301-980-4301",
        "authorized_official_credential": "MPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FYZICAL BonAir",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Derek C Diffendaffer, M.D.
• Jabria Monae Dillard, M.ED , LMHP-R CSAC-S
• Maria Dilucente, BCBA, LBA
• Ashlyn Dimmick, LPC
• Laura Dimmick, PSY.D.
• Divine Recovery Solutions LLC
• Jennifer Dean Dixon
• Khristina Dockery, RN
• Katherine Doctor, ATC
• Brittney Elizabeth Dodt, NP

• Physical Therapist in North Chesterfield, VA
• Providers in North Chesterfield, VA by specialty
• Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2023; 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.