Individual provider Active NPI

Robert Damon

  • Physical Therapist
  • Kilmarnock, VA
National Provider Identifier
1639289374
Registry record updated Mar 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
95 Harris Rd
BLDG #5
Kilmarnock, VA 22482-3845
Phone
(804) 285-2645
Fax
(804) 435-2172
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2017

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 Primary

Addresses

Primary practice location

95 Harris Rd
BLDG #5
Kilmarnock, VA 22482-3845

Mailing address

1115 Boulders Pkwy
Suite 200
North Chesterfield, VA 23225-4067
Phone (804) 560-5595

Other identifiers 1

IdentifierTypeStateIssuer
2305002054OtherVALICENSE#

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

Practice roles

OrganizationSpecialtyStatusNew patients
Orthovirginia, Inc CurrentSince Mar 27, 2017 Accepting new patients
Carousel Physical Therapy, Inc. Physical Therapist CurrentSince Aug 1, 2018 Accepting new patients
Orthovirginia Inc Physical Therapist Current Accepting new patients
Orthovirginia, Inc. CurrentSince Mar 27, 2017 Accepting new patients

Locations

95 Harris Rd
Bldg 5
Kilmarnock, VA 22482
Phone (804) 435-3146

500 Irvington Rd
Kilmarnock, VA 22482
Phone (804) 435-3435

8200 Meadowbridge Rd
Ste 200
Mechanicsville, VA 23116
Phone (804) 560-5595

1115 Boulders Pkwy
Ste 200
North Chesterfield, VA 23225
Phone (804) 327-9242

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490659200000",
    "number": "1639289374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 BOULDERS PKWY",
            "address_2": "SUITE 200",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232254067",
            "telephone_number": "804-560-5595",
            "fax_number": "804-560-9029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 HARRIS RD",
            "address_2": "BLDG #5",
            "city": "KILMARNOCK",
            "state": "VA",
            "postal_code": "224823845",
            "telephone_number": "804-285-2645",
            "fax_number": "804-435-2172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAMON",
        "first_name": "ROBERT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2017-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE#",
            "identifier": "2305002054",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kilmarnock, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2017; 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.