NPIMap

Organization Active NPI

Tracy M. Hernandez, Inc.

Doing business as Innovative Therapy & Wellness

  • Physical Therapist
  • Virginia Beach, VA
National Provider Identifier
1487664264
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
TRACY M. HERNANDEZ, INC.
Doing business as
Innovative Therapy & Wellness
Practice address
2224 Virginia Beach Blvd
Suite 106
Virginia Beach, VA 23454-4285
Phone
(757) 486-8663
Fax
(757) 486-2650
NPI assigned
Aug 8, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Tracy M. HernandezNPI 1053321802
Title
Owner
Phone
(757) 486-8663

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: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

2224 Virginia Beach Blvd
Suite 106
Virginia Beach, VA 23454-4285

Mailing address

2224 Virginia Beach Blvd
Suite 106
Virginia Beach, VA 23454-4285

Other names 1

  • Innovative Therapy & Wellness Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040423000477 VA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 7214923598 Receives reassigned benefits from 8 practitioners
Practice locations: Virginia Beach, VA

National Provider Directory

National Provider Directory

Locations

2224 Virginia Beach Blvd
Ste 106
Virginia Beach, VA 23454
Phone (757) 486-8663

Practitioners & affiliated clinicians

Practitioners 19

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.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1487664264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2224 VIRGINIA BEACH BLVD",
            "address_2": "SUITE 106",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234544285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2224 VIRGINIA BEACH BLVD",
            "address_2": "SUITE 106",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234544285",
            "telephone_number": "757-486-8663",
            "fax_number": "757-486-2650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRACY M. HERNANDEZ, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "757-486-8663"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Innovative Therapy & Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 22, 2020; 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.