Annerussell Moore Whitesel, DPT
Individual provider Active NPI Physical Therapist · Midlothian, VA
NPI 1497475198 · NPPES record last updated Dec 11, 2024
Key facts
- NPI
- 1497475198
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 2305215154 (VA)
- Practice address
- 14700 Village Square PL
Midlothian, VA 23112-2253 - Phone
- (276) 597-5159
- Fax
- (276) 597-5158
- NPI assigned
- Sep 1, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221122003157 | VA | Practitioner - Physical Therapist in Private Practice | 3577931559 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Acme Therapies Co | Physical Therapist | Current |
Accepting new patients |
| Melanie E. Canada | Past |
Accepting new patients |
Locations
128 Fayette St
Martinsville, VA 24112
Phone (276) 352-4465
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2305215154 | VA | Yes |
Addresses
Primary practice location
14700 Village Square PL
Midlothian, VA 23112-2253
Mailing address
14700 Village Square PL
Midlothian, VA 23112-2253
Phone (276) 597-5159
Other providers in Midlothian, VA
- Barrhonda White
- Claude White Jr.
- Joseph Scott White
- Linda Catherine White
- Pranee White
- Haley Whitfield
- Jacob Allen Whitley
- Michael Shawn Whitley Jr.
- Megan Whitney
- Whole Health Physicians, PC
All providers in Midlothian, 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 Dec 11, 2024. 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.