Individual provider Active NPI

Vikki Natasha Gaines, PT, DPT

  • Physical Therapist
  • Colonial Heights, VA
National Provider Identifier
1619573045
Registry record updated May 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305206769 Issued in VA
Practice address
300B Temple Lake Dr Ste 101
Colonial Heights, VA 23834-2973
Phone
(804) 524-9036
Fax
(804) 524-9039
NPI assigned
Dec 10, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2305206769 VA Primary

Addresses

Primary practice location

300B Temple Lake Dr Ste 101
Colonial Heights, VA 23834-2973

Mailing address

7224 Walking Horse Dr
Mechanicsville, VA 23111-1955
Phone (804) 683-3911

Other practice location 1

7600 Autumn Park Way
Mechanicsville, VA 23116-3868
Phone (804) 730-0009

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230608003062 VA Practitioner - Physical Therapist in Private Practice 8921465758 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
88.16 of 100Reported as group
Quality
85.78
Promoting interoperability
99
Improvement activities
40
Cost
75.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Washington Healthcare Physicians Physical Therapist CurrentSince Nov 18, 2024 Accepting new patients
Tidewater Physical Therapy, LLC Physical Therapist CurrentSince May 1, 2023 Accepting new patients
Mary Washington Healthcare Physicians CurrentSince Nov 18, 2024 Accepting new patients
Tidewater Physical Therapy, LLC Physical Therapist CurrentSince May 1, 2023 Accepting new patients

Locations

300B Temple Lake Dr
Ste 1
Colonial Heights, VA 23834
Phone (804) 452-4903

1001 Sam Perry Blvd
Fredericksburg, VA 22401
Phone (540) 741-1100

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

12494 Warwick Blvd
Newport News, VA 23606
Phone (804) 217-9210

90 Greenspring Dr
Stafford, VA 22554
Phone (540) 373-7133

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1607558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685491200000",
    "number": "1619573045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7224 WALKING HORSE DR",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "231111955",
            "telephone_number": "804-683-3911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300B TEMPLE LAKE DR STE 101",
            "city": "COLONIAL HEIGHTS",
            "state": "VA",
            "postal_code": "238342973",
            "telephone_number": "804-524-9036",
            "fax_number": "804-524-9039"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7600 Autumn Park Way",
            "address_purpose": "LOCATION",
            "city": "Mechanicsville",
            "state": "VA",
            "postal_code": "231163868",
            "country_code": "US",
            "telephone_number": "804-730-0009",
            "fax_number": "804-730-0047",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAINES",
        "first_name": "VIKKI",
        "middle_name": "NATASHA",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-10",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305206769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colonial Heights, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2023; 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.