Individual provider Active NPI

Adam C Weisenborn, OTR/L

  • Occupational Therapist
  • Virginia Beach, VA
National Provider Identifier
1467008136
Registry record updated Aug 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
0119008241 Issued in VA
Practice address
1717 Will O Wisp Dr Ste 100
Virginia Beach, VA 23454-3102
Phone
(757) 422-8476
Fax
(804) 435-2172
NPI assigned
Aug 17, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 0119008241 VA Primary

Addresses

Primary practice location

1717 Will O Wisp Dr Ste 100
Virginia Beach, VA 23454-3102

Mailing address

PO Box 715868
Philadelphia, PA 19171-5868
Phone (804) 915-1910

Other practice location 1

901 Enterprise Pkwy Ste 900
Hampton, VA 23666-6250
Phone (757) 827-2480

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191104003189 VA Practitioner - Occupational Therapist in Private Practice 5496087850 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tidewater Orthopaedic Associates Inc.Group PAC ID 2466345814, 26 clinicians

Practice addresses (Care Compare)

901 Enterprise Pkwy
Suite 900
Hampton, VA 23666-6250
Phone (757) 827-2480

Merit-based Incentive Payment System (MIPS)

Final score
94.1 of 100Reported as group
Quality
91.92
Promoting interoperability
97
Improvement activities
40
Cost
90.92

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0119-008241VAMDHand Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Tidewater Orthopaedic Associates Inc Physical Therapist CurrentSince Sep 1, 2019 Accepting new patients
Tidewater Orthopaedic Associates Inc CurrentSince Sep 1, 2019 Accepting new patients
Hampton Roads Otolaryngology Associates PLLC PastSince Aug 1, 2019 Accepting new patients
Tidewater Orthopaedic Associates Occupational Therapy Past Accepting new patients

Locations

901 Enterprise Pkwy
Hampton, VA 23666
Phone (757) 827-2480

901 Enterprise Pkwy
Ste 900
Hampton, VA 23666
Phone (757) 827-2480

4037 Ironbound Rd
Williamsburg, VA 23188
Phone (757) 206-1004

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BCCHBA

Organizations & group practices 4

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": "1566000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788134400000",
    "number": "1467008136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 715868",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191715868",
            "telephone_number": "804-915-1910",
            "fax_number": "804-968-1803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 WILL O WISP DR STE 100",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234543102",
            "telephone_number": "757-422-8476",
            "fax_number": "804-435-2172"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "901 Enterprise Pkwy Ste 900",
            "address_purpose": "LOCATION",
            "city": "Hampton",
            "state": "VA",
            "postal_code": "236666250",
            "country_code": "US",
            "telephone_number": "757-827-2480",
            "fax_number": "757-827-2566",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEISENBORN",
        "first_name": "ADAM",
        "middle_name": "C",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-17",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "VA",
            "license": "0119008241",
            "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 Aug 31, 2026; 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.