Individual provider Active NPI

Benjamin Stuckey, PT, DPT, COTA, CSCS

  • Physical Therapist
  • Chesapeake, VA
National Provider Identifier
1538728696
Registry record updated Nov 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
CP030726T Issued in VA
Practice address
680 Kingsborough SQ Ste B
Chesapeake, VA 23320-4988
Phone
(757) 547-0434
Fax
(757) 547-0625
NPI assigned
Jun 11, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 16245-24 WI
Physical Therapist 225100000X CP030726T VA Primary
Physical Therapist 225100000X P21981 NC

Addresses

Primary practice location

680 Kingsborough SQ Ste B
Chesapeake, VA 23320-4988

Mailing address

PO Box 412307
Boston, MA 02241-2307
Phone (914) 294-4050

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address him@marshfieldclinichealthsystem.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250220003256 VA Practitioner - Physical Therapist in Private Practice 9133649148 Reassigns benefits to 2 organizations
I20250418000036 WI Practitioner - Physical Therapist in Private Practice 9133649148 Reassigns benefits to 9 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ivyrehab Sept, LLCGroup PAC ID 7911990908, 216 clinicians

Practice addresses (Care Compare)

680 Kingsborough SQ
Suite B
Chesapeake, VA 23320-4988
Phone (757) 547-0434

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P21981NCMDPhysical Therapist
16245-24WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
MCHS Hospitals Inc CurrentSince Apr 21, 2025 Accepting new patients
Flambeau Hospital Inc Current Accepting new patients
Marshfield Clinic Inc CurrentSince Apr 21, 2025 Accepting new patients
MCHS Hospitals Inc CurrentSince Apr 21, 2025 Accepting new patients
Memorial Hospital Inc CurrentSince Apr 21, 2025 Accepting new patients
MCHS Hospitals Inc Current Accepting new patients
Ivyrehab Sept, LLC Physical Therapist CurrentSince Nov 1, 2025 Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Apr 21, 2025 Accepting new patients
Tidewater Physical Therapy, LLC Physical Therapist CurrentSince Jan 9, 2025 Accepting new patients
Tidewater Physical Therapy, LLC Physical Therapist CurrentSince Jan 9, 2025 Accepting new patients
Tidewater Physical Therapy, LLC Physical Therapist Current Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Apr 21, 2025 Accepting new patients
Flambeau Hospital Inc CurrentSince Apr 21, 2025 Accepting new patients
MCHS Hospitals Inc Current Accepting new patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Apr 21, 2025 Accepting new patients
Ivyrehab Sept, LLC Physical Therapist CurrentSince Nov 1, 2025 Accepting new patients

Locations

2122 York Rd
Ste 300
Oak Brook, IL 60523
Phone (630) 575-6250

2275 Beech Ave
Buena Vista, VA 24416
Phone (540) 466-1000

680 Kingsborough Sq
Ste B
Chesapeake, VA 23320
Phone (757) 547-0434

10518 Spotsylvania Ave
#100
Fredericksburg, VA 22408
Phone (540) 710-5341

10128 W Broad St
Bldg Iii
Glen Allen, VA 23060
Phone (804) 217-9210

705 S University Ave
Beaver Dam, WI 53916
Phone (920) 885-6090

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

1102 S Center Ave
Merrill, WI 54452
Phone (715) 536-3399

N3708 River Ave
Neillsville, WI 54456
Phone (715) 743-3101

1700 W Stout St
Rice Lake, WI 54868
Phone (715) 236-6133

Interoperability endpoints

  • Direct secure messaging: him@marshfieldclinichealthsystem.cernerdirect.com

Organizations & group practices 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1560211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763424000000",
    "number": "1538728696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 412307",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022412307",
            "telephone_number": "914-294-4050",
            "fax_number": "631-760-8306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 KINGSBOROUGH SQ STE B",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233204988",
            "telephone_number": "757-547-0434",
            "fax_number": "757-547-0625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUCKEY",
        "first_name": "BENJAMIN",
        "credential": "PT, DPT, COTA, CSCS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-11",
        "last_updated": "2025-11-18",
        "certification_date": "2025-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "16245-24",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "CP030726T",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P21981",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@marshfieldclinichealthsystem.cernerdirect.com",
            "affiliation": "N",
            "address_1": "Marshfield Clinic",
            "address_2": "1000 N Oak Avenue",
            "city": "Marshfield",
            "state": "WI",
            "country_code": "US",
            "postal_code": "544495703",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Nov 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.