King William Physical Therapy

Primary specialty

Comprehensive Outpatient Rehabilitation Facility (CORF)Taxonomy code 261QR0401X

License

S094294-8 Issued in VA

Legal business name

KING WILLIAM PHYSICAL THERAPY

Practice address

5983 Richmond Tappahannock Hwy
Aylett, VA 23009-3009

Phone

(804) 769-7504

Fax

(804) 769-7524

NPI assigned

Dec 17, 2007

Last updated

Feb 22, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Timothy Wayne McDaniel, P.T.NPI 1427068139

Title

Owner

Phone

(804) 769-7504

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Locations

Practitioners 7

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.

• Timothy Wayne McDaniel, P.T.

  • Physical Therapist
  • King William, VA
  • NPI 1427068139
  Medicare reassignment NPD Authorized official
• Phyllis Grimmer Eberline, PT,DPT

  • Physical Therapist
  • Tappahannock, VA
  • NPI 1699037804
  Medicare reassignment NPD
• Lance Edward Townsend, PT

  • Physical Therapist
  • Aylett, VA
  • NPI 1841449949
  Medicare reassignment NPD
• Jenny Place, DPT

  • Physical Therapist
  • Ashland, VA
  • NPI 1043611551
  NPD
• Mackenzie Ryan Taylor, PT, DPT

  • Physical Therapist
  • Aylett, VA
  • NPI 1902791213
  NPD
• Martha Lelia McDaniel, OTR/L

  • Occupational Therapist
  • Blacksburg, VA
  • NPI 1972730406
  NPD (past)
• Colton Leland McGhee, ATC

  • Athletic Trainer
  • Aylett, VA
  • NPI 1023670288
  NPD (past)

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

{
    "created_epoch": "1197849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677024000000",
    "number": "1508049255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5983 RICHMOND TAPPAHANNOCK HWY",
            "city": "AYLETT",
            "state": "VA",
            "postal_code": "230093009",
            "telephone_number": "804-769-7504",
            "fax_number": "804-769-7524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5983 RICHMOND TAPPAHANNOCK HWY",
            "city": "AYLETT",
            "state": "VA",
            "postal_code": "230093009",
            "telephone_number": "804-769-7504",
            "fax_number": "804-769-7524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KING WILLIAM PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-17",
        "last_updated": "2023-02-22",
        "certification_date": "2023-02-22",
        "status": "A",
        "authorized_official_last_name": "MCDANIEL",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "804-769-7504",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": "VA",
            "license": "S094294-8",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010029686",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lauren Jenkins
• Aleyah Chanel Kelly
• Geri Nicole Kennedy
• King William County Board of Supervisors (King William County EMS)
• King William Pharmacy Inc
• King William Volunteer Fire and Rescue
• Augustine Warner Lewis III
• Grace Limbaugh
• Anna A Limberger, PT, PHD
• Sara Eleanor Hooper Majewski, NP

• Comprehensive Outpatient Rehabilitation Facility (CORF) in Aylett, VA
• Providers in Aylett, VA by specialty
• Comprehensive Outpatient Rehabilitation Facility (CORF) in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2023; 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.