Active NPI
Janice M Gomoke, PT
- Physical Therapist
- Chesapeake, VA
National Provider Identifier
1508887597
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2305002436
- Practice address
- 4020 Raintree Rd Ste D
Chesapeake, VA 23321-3749 - Phone
- (757) 484-4241
- Fax
- (757) 484-4487
- NPI assigned
- Jul 22, 2006
- Sex
- Female
- 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 | 2305002436 | VA | Primary |
Addresses
Primary practice location
4020 Raintree Rd Ste D
Chesapeake, VA 23321-3749
Mailing address
PO Box 69030
Baltimore, MD 21264-9030
Phone (757) 873-2302
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508887597 | Medicaid | VA | |
| 010208793 | Medicaid | VA | |
| P00233936 | Other | VA | MEDICARE RR |
| 192941 | Other | VA | BCBS (PHYSICAL THERAPY) |
| 7899071 | Other | VA | AETNA |
| P00871013 | Other | VA | MEDICARE RAILROAD |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153526400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1523836800000",
"number": "1508887597",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 69030",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212649030",
"telephone_number": "757-873-2302",
"fax_number": "757-873-2306"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4020 RAINTREE RD STE D",
"city": "CHESAPEAKE",
"state": "VA",
"postal_code": "233213749",
"telephone_number": "757-484-4241",
"fax_number": "757-484-4487"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOMOKE",
"first_name": "JANICE",
"middle_name": "M",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-22",
"last_updated": "2018-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "VA",
"license": "2305002436",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1508887597",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "010208793",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RR",
"identifier": "P00233936",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS (PHYSICAL THERAPY)",
"identifier": "192941",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7899071",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "P00871013",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chesapeake, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.