Active NPI
Tracy Constable Bates, PT
- Physical Therapist
- Midlothian, VA
National Provider Identifier
1619083953
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2305005264
- Practice address
- 13700 St Francis Blvd
Ste 103
Midlothian, VA 23114-3222 - Phone
- (804) 379-2414
- Fax
- (804) 379-2413
- NPI assigned
- Aug 21, 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 | 2305005264 | VA | Primary |
Addresses
Primary practice location
13700 St Francis Blvd
Ste 103
Midlothian, VA 23114-3222
Mailing address
1518 Denby Way
Midlothian, VA 23114-4321
Phone (804) 378-2227
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2305005264 | VA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196208000000",
"number": "1619083953",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1518 DENBY WAY",
"city": "MIDLOTHIAN",
"state": "VA",
"postal_code": "231144321",
"telephone_number": "804-378-2227"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13700 ST FRANCIS BLVD",
"address_2": "STE 103",
"city": "MIDLOTHIAN",
"state": "VA",
"postal_code": "231143222",
"telephone_number": "804-379-2414",
"fax_number": "804-379-2413"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BATES",
"first_name": "TRACY",
"middle_name": "CONSTABLE",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-21",
"last_updated": "2007-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "VA",
"license": "2305005264",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Midlothian, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.