Active NPI
Valerie Villarin
- Physical Therapist
- Jacksonville, NC
National Provider Identifier
1467850651
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- P23107
- Practice address
- 2457 Gum Branch Rd Ste 600700
Jacksonville, NC 28540-4008 - Phone
- (910) 938-7555
- NPI assigned
- Dec 20, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 41278 | CA | |
| Physical Therapist | 225100000X | 63356 | OR | |
| Physical Therapist | 225100000X | P23107 | NC | Primary |
Addresses
Primary practice location
2457 Gum Branch Rd Ste 600700
Jacksonville, NC 28540-4008
Mailing address
3303 S Bond Ave
Portland, OR 97239-4501
Phone (503) 494-3151
Other practice location 1
100 Brewster Blvd
Camp Lejeune, NC 28547-2575
Phone (910) 499-1152
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P23107 | NC | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peak Performance Sports and Physical Therapy, LLC | Physical Therapist | Past | Accepting new patients |
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.
-
- Physical Therapist
- New Bern, NC
- NPI 1194714063
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1419033600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728259200000",
"number": "1467850651",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3303 S BOND AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972394501",
"telephone_number": "503-494-3151",
"fax_number": "503-418-9473"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2457 GUM BRANCH RD STE 600700",
"city": "JACKSONVILLE",
"state": "NC",
"postal_code": "285404008",
"telephone_number": "910-938-7555"
}
],
"practiceLocations": [
{
"address_1": "100 Brewster Blvd",
"address_purpose": "LOCATION",
"city": "Camp Lejeune",
"state": "NC",
"postal_code": "285472575",
"country_code": "US",
"telephone_number": "910-499-1152",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VILLARIN",
"first_name": "VALERIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-12-20",
"last_updated": "2024-10-07",
"certification_date": "2024-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "41278",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OR",
"license": "63356",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "P23107",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.