Individual provider Active NPI

Bruce Edwards Pearce Jr., D.P.T.

  • Physical Therapist
  • Henrico, VA
National Provider Identifier
1649655986
Registry record updated Apr 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305209538 Issued in VA
Practice address
11809 Shady Wood CT
Henrico, VA 23233-2500
Phone
(434) 579-1434
NPI assigned
Jul 28, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 2022

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 2305209538 VA Primary

Addresses

Primary practice location

11809 Shady Wood CT
Henrico, VA 23233-2500

Mailing address

11809 Shady Wood CT
Henrico, VA 23233-2500
Phone (434) 579-1434

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220620001776 DC Practitioner - Physical Therapist in Private Practice 6608282801 Reassigns benefits to 1 organization
I20220721000874 VA Practitioner - Physical Therapist in Private Practice 6608282801 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

7 Carnegie PLZ
Cherry Hill, NJ 08003-1000

7 Clyde Rd
Somerset, NJ 08873-5049

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehabilitation Services LLC Physical Therapist CurrentSince May 1, 2022 Accepting new patients
Cardiac Connections Home Health Care Nursing Services Corp. PastSince Jul 10, 2020 Accepting new patients

Locations

7 Carnegie Plz
Cherry Hill, NJ 08003

20 E Piccadilly St
Ste 1114
Winchester, VA 22601

Organizations & group practices 2

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": "1438041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649808000000",
    "number": "1649655986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11809 SHADY WOOD CT",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232332500",
            "telephone_number": "434-579-1434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11809 SHADY WOOD CT",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232332500",
            "telephone_number": "434-579-1434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEARCE",
        "first_name": "BRUCE",
        "middle_name": "EDWARDS",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-28",
        "last_updated": "2022-04-13",
        "certification_date": "2022-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305209538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henrico, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2022; 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.