Individual provider Active NPI

Sage Hutton

  • Physical Therapist
  • Fredericksburg, VA
National Provider Identifier
1629430657
Registry record updated Mar 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305210676 Issued in VA
Practice address
4932 Southpoint Pkwy
Fredericksburg, VA 22407-2659
Phone
(540) 891-1186
NPI assigned
Mar 29, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 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 2305210676 VA Primary

Addresses

Primary practice location

4932 Southpoint Pkwy
Fredericksburg, VA 22407-2659

Mailing address

3522 Missouri Ave
Richmond, VA 23222-2942
Phone (860) 558-6758

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240409003920 VA Practitioner - Physical Therapist in Private Practice 3173812096 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2305210676VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Select Physical Therapy Holdings, Inc. Physical Therapist Current Accepting new patients
Select Physical Therapy Holdings Inc CurrentSince Jan 22, 2024 Accepting new patients
Select Physical Therapy Holdings Inc CurrentSince Jan 22, 2024 Accepting new patients
Motion Works Physical Therapy, LLC Physical Therapist PastSince Dec 21, 2016 Accepting new patients

Locations

7500 Jackson Arch Dr
Ste G
Mechanicsville, VA 23111
Phone (804) 559-2900

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": "1459209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677628800000",
    "number": "1629430657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3522 MISSOURI AVE",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232222942",
            "telephone_number": "860-558-6758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4932 SOUTHPOINT PKWY",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224072659",
            "telephone_number": "540-891-1186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUTTON",
        "first_name": "SAGE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-29",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305210676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.