Individual provider Active NPI

Diane Elizabeth McCann, PT, DPT, CSCS

  • Physical Therapist
  • Norfolk, VA
National Provider Identifier
1639328560
Registry record updated May 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305205658 Issued in VA
Practice address
154 E Little Creek Rd
Norfolk, VA 23505-2503
Phone
(757) 797-0210
Fax
(757) 453-1550
NPI assigned
Sep 16, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2020

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 2305205658 VA Primary

Addresses

Primary practice location

154 E Little Creek Rd
Norfolk, VA 23505-2503

Mailing address

350 New Fidelity CT
Garner, NC 27529-2665
Phone (919) 258-2714

Other identifiers 3

IdentifierTypeStateIssuer
1639328560OtherVAMEDICAID QMB
C05954OtherVAGROUP MEDICARE PTAN
004979796MedicaidVA

Other names 1

  • Diane E Hutchins Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130206000426 VA Practitioner - Physical Therapist in Private Practice 1355536046 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tidewater Physical Therapy LLCGroup PAC ID 6406759281, 225 clinicians

Practice addresses (Care Compare)

10128 W Broad St
Forum Building III Suite K
Glen Allen, VA 23060-6761
Phone (804) 217-9210

154 E Little Creek Rd
Norfolk, VA 23505-2503
Phone (757) 797-0210

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
Tidewater Physical Therapy, LLC Physical Therapist CurrentSince Nov 28, 2012 Accepting new patients
Tidewater Physical Therapy, LLC Physical Therapist CurrentSince Nov 28, 2012 Accepting new patients
Tidewater Physical Therapy LLC Physical Therapist Past Accepting new patients
Tidewater Physical Therapy, LLC Physical Therapist Past Accepting new patients
Tidewater Physical Therapy, LLC Physical Therapist Past Accepting new patients
Tidewater Physical Therapy LLC Physical Therapist Past Accepting new patients
Tidewater Physical Therapy LLC Physical Therapist Past Accepting new patients

Locations

350 New Fidelity Ct
Garner, NC 27529
Phone (919) 373-2919

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

154 E Little Creek Rd
Norfolk, VA 23505
Phone (757) 797-0210

Organizations & group practices 7

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": "1221523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590624000000",
    "number": "1639328560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 NEW FIDELITY CT",
            "city": "GARNER",
            "state": "NC",
            "postal_code": "275292665",
            "telephone_number": "919-258-2714",
            "fax_number": "410-648-4878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "154 E LITTLE CREEK RD",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235052503",
            "telephone_number": "757-797-0210",
            "fax_number": "757-453-1550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCANN",
        "first_name": "DIANE",
        "middle_name": "ELIZABETH",
        "credential": "PT, DPT, CSCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-16",
        "last_updated": "2020-05-28",
        "certification_date": "2020-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305205658",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID QMB",
            "identifier": "1639328560",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE PTAN",
            "identifier": "C05954",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004979796",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANE",
            "last_name": "HUTCHINS",
            "middle_name": "E",
            "credential": "PT, DPT, CSCS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Norfolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2020; 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.