Individual provider Active NPI

Aileen Marie McKernan

  • Physical Therapist
  • Barboursville, VA
National Provider Identifier
1487981122
Registry record updated May 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305206297 Issued in VA
Practice address
5924 Seminole TRL
Suite 108
Barboursville, VA 22923-1505
Phone
(434) 985-2198
NPI assigned
Nov 16, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2305206297 VA Primary

Addresses

Primary practice location

5924 Seminole TRL
Suite 108
Barboursville, VA 22923-1505

Mailing address

226 Burnet St
Charlottesville, VA 22902-6196
Phone (434) 981-2701

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091231000196 VA Practitioner - Physical Therapist in Private Practice 5597806364 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2305206297VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Healthcare Services Inc Physical Therapist CurrentSince May 1, 2023 Accepting new patients
Legacy Healthcare Services Inc Physical Therapist CurrentSince May 1, 2023 Accepting new patients
Phoenix Rehabilitation and Health Services of Virginia, LLC Physical Therapist PastSince Apr 4, 2005 Accepting new patients

Locations

110 Horizon Dr
#310
Raleigh, NC 27615

343 Archer Ave
Charlottesville, VA 22911
Phone (434) 255-0996

3365 Ogden Rd
Roanoke, VA 24018
Phone (540) 682-7500

Organizations & group practices 3

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": "1258329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1495756800000",
    "number": "1487981122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "226 BURNET ST",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229026196",
            "telephone_number": "434-981-2701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5924 SEMINOLE TRL",
            "address_2": "SUITE 108",
            "city": "BARBOURSVILLE",
            "state": "VA",
            "postal_code": "229231505",
            "telephone_number": "434-985-2198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKERNAN",
        "first_name": "AILEEN",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-16",
        "last_updated": "2017-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305206297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Barboursville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2017; 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.