Individual provider Active NPI

Timothy E. Blake, PT, DPT, CSCS

  • Physical Therapist
  • Richmond, VA
National Provider Identifier
1649602723
Registry record updated Jul 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305208076 Issued in VA
Practice address
5899 Bremo Rd
Suite 100
Richmond, VA 23226-1935
Phone
(804) 285-2645
Fax
(804) 287-2786
NPI assigned
Jul 31, 2013
Last updated
Jul 1, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2026

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 2305208076 VA Primary

Addresses

Primary practice location

5899 Bremo Rd
Suite 100
Richmond, VA 23226-1935

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
1649602723OtherVAMEDICAID QMB ONLY
C05954OtherVAGROUP MEDICARE PTAN

Electronic endpoints 4

TypeEndpointUseAffiliation
CONNECT URL https://www.cms.gov/data-research/computer-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler Other
CONNECT URL https://www.cms.gov/data-research/computer-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler Other Fox Rehab PT MD LLC
CONNECT URL https://www.cms.gov/data-research/computer-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler Other Fox Rehab PT MD LLC
CONNECT URL https://www.cms.gov/data-research/computer-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler Other Fox Rehab PT MD LLC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20131001000262 VA Practitioner - Physical Therapist in Private Practice 6507090701 Reassigns benefits to 1 organization
I20260616000921 DC Practitioner - Physical Therapist in Private Practice 6507090701 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fox Rehabilitation Services LLCGroup PAC ID 1355347410, 304 clinicians

Practice addresses (Care Compare)

3925 Downs Dr
Chantilly, VA 20151-3308
Phone (703) 810-3992

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehabilitation Services LLC Physical Therapist CurrentSince Dec 1, 2022 Accepting new patients

Locations

7 Carnegie Plz
Cherry Hill, NJ 08003

20 E Piccadilly St
Ste 1114
Winchester, VA 22601

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1375228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782864000000",
    "number": "1649602723",
    "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": "5899 BREMO RD",
            "address_2": "SUITE 100",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232261935",
            "telephone_number": "804-285-2645",
            "fax_number": "804-287-2786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "TIMOTHY",
        "middle_name": "E.",
        "credential": "PT, DPT, CSCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-31",
        "last_updated": "2026-07-01",
        "certification_date": "2026-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305208076",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID QMB ONLY",
            "identifier": "1649602723",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE PTAN",
            "identifier": "C05954",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cms.gov/data-research/computer-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler",
            "affiliation": "N",
            "endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "11665 Doolittle Dr",
            "city": "Waldorf",
            "state": "MD",
            "country_code": "US",
            "postal_code": "206022898",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cms.gov/data-research/computer-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
            "affiliationName": "Fox Rehab PT MD LLC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "6451 N Charles St",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212121010",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cms.gov/data-research/computer-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
            "affiliationName": "Fox Rehab PT MD LLC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "7819 Rocky Springs Rd",
            "city": "Frederick",
            "state": "MD",
            "country_code": "US",
            "postal_code": "217022824",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cms.gov/data-research/computer-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
            "affiliationName": "Fox Rehab PT MD LLC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "9708 Belair Rd",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212361108",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2026; 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.