Nova Neuro Rehab PLLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

NOVA NEURO REHAB PLLC

Practice address

400 Madison St Apt 1406
Alexandria, VA 22314-1724

Phone

(901) 288-8063

NPI assigned

May 29, 2024

Last updated

Jun 17, 2024By 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

Cameron Waggoner, PT, DPT, NCSNPI 1639645245

Title

Owner/Managing Member

Phone

(901) 288-8063

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Cameron Waggoner, PT, DPT, NCS

  • Physical Therapist
  • Alexandria, VA
  • NPI 1639645245
  NPD Authorized official

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

{
    "created_epoch": "1716940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718582400000",
    "number": "1518707322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25451",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223135451",
            "telephone_number": "901-288-8063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 MADISON ST APT 1406",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223141724",
            "telephone_number": "901-288-8063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVA NEURO REHAB PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-29",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A",
        "authorized_official_last_name": "WAGGONER",
        "authorized_official_first_name": "CAMERON",
        "authorized_official_title_or_position": "OWNER/MANAGING MEMBER",
        "authorized_official_telephone_number": "901-288-8063",
        "authorized_official_credential": "PT, DPT, NCS"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nova Elderly Home Care LLC (Visiting Angels)
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• Nova Eye Physicians & Surgeons
• Nova Foot & Ankle Center, LLC
• Nova Gynecology Associates LLC
• Nova Pain Clinic Inc
• Nova Pediatric Therapy, PLLC
• Nova Portable Xray LLC
• Nova Psychotherapy and Assessment
• Nova Sports and Spine Physical Therapy (Nova Sports and Spine Rehab)

• Physical Therapist in Alexandria, VA
• Providers in Alexandria, VA by specialty
• Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.