NPIMap

Organization Active NPI

Lymphedema and Rehabilitation Consultants ,PLLC

  • Physical Therapist
  • Glen Allen, VA
National Provider Identifier
1497204630
Registry record updated Aug 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
LYMPHEDEMA AND REHABILITATION CONSULTANTS ,PLLC
Practice address
2916 Ridgegate PL
Glen Allen, VA 23059-4682
Phone
(517) 918-4849
NPI assigned
Sep 29, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2019

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

Authorized official

Name
Mr. Kirat S Shah, PTNPI 1942697602
Title
Member
Phone
(804) 505-4849

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

2916 Ridgegate PL
Glen Allen, VA 23059-4682

Mailing address

2916 Ridgegate PL
Glen Allen, VA 23059-4682
Phone (804) 505-4849

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161228001754 VA Part B Supplier - Clinic/Group Practice 0648551952 Receives reassigned benefits from 6 practitioners
Practice locations: Colonial Heights, VA; Glen Allen, VA; Mechanicsville, VA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1475107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566777600000",
    "number": "1497204630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2916 RIDGEGATE PL",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230594682",
            "telephone_number": "804-505-4849",
            "fax_number": "844-715-9467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2916 RIDGEGATE PL",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230594682",
            "telephone_number": "517-918-4849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LYMPHEDEMA AND REHABILITATION CONSULTANTS ,PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-29",
        "last_updated": "2019-08-26",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "KIRAT",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "804-505-4849",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Allen, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2019; 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.