Old Dominion Physical Medicine PLLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

0101253471 Issued in VA

Legal business name

OLD DOMINION PHYSICAL MEDICINE PLLC

Practice address

5700 Fitzhugh Ave
Healthsouth Rehabilitation Hospital
Richmond, VA 23226-1800

Phone

(804) 521-5310

NPI assigned

Mar 26, 2015

Organization subpart

No

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

Authorized official

Name

Todd A Wichman, M.D.NPI 1437265717

Title

Owner

Phone

(804) 521-5310

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Locations

Practitioners 1

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

• Todd Anthony Wichman, MD

  • Physical Medicine & Rehabilitation Physician
  • Midlothian, VA
  • NPI 1437265717
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1427328000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427328000000",
    "number": "1508250697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 WESTERRE PKWY",
            "address_2": "SUITE 300",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232331478",
            "telephone_number": "804-521-5310",
            "fax_number": "804-477-1252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 FITZHUGH AVE",
            "address_2": "HEALTHSOUTH REHABILITATION HOSPITAL",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232261800",
            "telephone_number": "804-521-5310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLD DOMINION PHYSICAL MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-26",
        "last_updated": "2015-03-26",
        "status": "A",
        "authorized_official_last_name": "WICHMAN",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "804-521-5310",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "VA",
            "license": "0101253471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary E Olbrisch, PH.D.
• Old Dominion Home Health Services
• Old Dominion Home Health Services Inc
• Old Dominion Home Health Services Inc
• Old Dominion Medical Staffing Agency LLC
• Old Glory Home Health Care & Assistive Care
• Old Glory Personalized Health
• Robert A. Older, M.D.
• Sarah Katherine Oldham, PA, RDN
• Tawana Toneke Olds-Davis, L.C.S.W

• Physical Medicine & Rehabilitation Physician in Richmond, VA
• Providers in Richmond, VA by specialty
• Physical Medicine & Rehabilitation Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2015; 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.