Active NPI
Lee Irvin Boehm, PT
- Physical Therapist
- Norfolk, VA
National Provider Identifier
1497768766
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2305204645
- Practice address
- 951 W 21St St
Norfolk, VA 23517-1534 - Phone
- (757) 623-0867
- Fax
- (757) 627-2923
- NPI assigned
- Aug 15, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2305204645 | VA | Primary |
Addresses
Primary practice location
951 W 21St St
Norfolk, VA 23517-1534
Mailing address
242 Mustang TRL
Suite 2
Virginia Beach, VA 23452-7515
Phone (757) 481-6981
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2305204645 | VA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prohealth | Physical Therapist | Past | Accepting new patients |
| Advanced Physical Therapy, Inc | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Physical Therapist
- Coppell, TX
- NPI 1033130828
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193184000000",
"number": "1497768766",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "242 MUSTANG TRL",
"address_2": "SUITE 2",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234527515",
"telephone_number": "757-481-6981",
"fax_number": "757-481-6175"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "951 W 21ST ST",
"city": "NORFOLK",
"state": "VA",
"postal_code": "235171534",
"telephone_number": "757-623-0867",
"fax_number": "757-627-2923"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOEHM",
"first_name": "LEE",
"middle_name": "IRVIN",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-15",
"last_updated": "2007-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "VA",
"license": "2305204645",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Norfolk, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.