NPIMap

Organization Active NPI

Ezephysical Therapy LLC

  • Physical Therapist
  • Chase City, VA
National Provider Identifier
1477047280
Registry record updated Jun 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305206212 Issued in 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
Last updated
Jun 15, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2018

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

Authorized official

Name
Mr. Jagdeep Singh, PTNPI 1356710735
Title
Physical Therapist
Phone
(586) 219-7872

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X 2305206212 VA Primary

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

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

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

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1529020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529020800000",
    "number": "1477047280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 BERNARD ST",
            "city": "SOUTH BOSTON",
            "state": "VA",
            "postal_code": "245922611",
            "telephone_number": "586-219-7872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 N MAIN ST",
            "city": "CHASE CITY",
            "state": "VA",
            "postal_code": "239241609",
            "telephone_number": "586-219-7872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EZEPHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-15",
        "last_updated": "2018-06-15",
        "status": "A",
        "authorized_official_last_name": "SINGH",
        "authorized_official_first_name": "JAGDEEP",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "586-219-7872",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305206212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chase City, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2018; 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.