Ezephysical Therapy LLC
Organization Active NPI Physical Therapist · Chase City, VA
NPI 1477047280 · NPPES record last updated Jun 15, 2018
Key facts
- NPI
- 1477047280
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapist 225100000X
- License
- 2305206212 (VA)
- Legal business name
- EZEPHYSICAL THERAPY LLC
- Practice address
- 141 N Main St
Chase City, VA 23924-1609 - Phone
- (586) 219-7872
- NPI assigned
- Jun 15, 2018
- Organization subpart
- No
Authorized official
- Name
- Mr. Jagdeep Singh, PT
- Title
- Physical Therapist
- Phone
- (586) 219-7872
Practitioners 9
-
Laura Hall, DPT
-
Leigh-Anne Nicole Witcher, PT, DPT
-
Janet Holt Durham, FNP-BC
-
Barbara Wilkinson Morrison, OTR/L, CLT, WCC
-
Brigitte Gil Lacy, MS, CCC-SLP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190417001902 | VA | Part B Supplier - Physical/Occupational Therapy Group in Private Practice | 2860738010 |
Receives reassigned benefits from 7 practitioners Practice locations: South Boston, VA; Chase City, VA |
National Provider Directory
Locations
503 N Main St
Chase City, VA 23924
Phone (434) 533-3367
1100 Confroy Dr
Ste 3
South Boston, VA 24592
Phone (434) 917-8046
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | 2305206212 | VA | Yes |
Addresses
Primary practice location
141 N Main St
Chase City, VA 23924-1609
Mailing address
1311 Bernard St
South Boston, VA 24592-2611
Phone (586) 219-7872
Other providers in Chase City, VA
- Amy Katherine Daniels
- Stacy Davis
- Martin Tyler Deal
- Dominion Health Medical Assoc
- Debora Ann Duckett
- Danielle Delilah Faught
- Miranda Fields
- Mandy Antoinette Fisher
- FW Richards Jr Inc
- Mark Joseph Hairston
All providers in Chase City, VA · Physical Therapist in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 15, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.