Individual provider Active NPI

Jeffrey D Fanney, PT, DPT

  • Physical Therapist
  • Palmyra, VA
National Provider Identifier
1649885807
Registry record updated Apr 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305213854 Issued in VA
Practice address
109 Crofton PL
Palmyra, VA 22963-3300
Phone
(434) 589-9588
Fax
(434) 589-4096
NPI assigned
Sep 14, 2020
Last updated
Apr 8, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2024

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 2305213854 VA Primary

Addresses

Primary practice location

109 Crofton PL
Palmyra, VA 22963-3300

Mailing address

1377 Motor Pkwy Ste 307
Islandia, NY 11749-5258
Phone (631) 580-5200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220419002486 VA Practitioner - Physical Therapist in Private Practice 1951798040 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ivyrehab Sept, LLCGroup PAC ID 7911990908, 216 clinicians

Practice addresses (Care Compare)

109 Crofton PL
Palmyra, VA 22963-3300
Phone (434) 589-9588

Merit-based Incentive Payment System (MIPS)

Final score
91.57 of 100Reported as group
Quality
98.54
Improvement activities
40
Cost
74.59

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2305213854VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rehabilitation Associates of Central Virginia Limited Partnership Physical Therapist CurrentSince Feb 28, 2022 Accepting new patients
Ivyrehab Sept, LLC Physical Therapist CurrentSince May 20, 2024 Accepting new patients
Rehabilitation Associates of Central Virginia Limited Partnership Physical Therapist CurrentSince Feb 28, 2022 Accepting new patients
Ivyrehab Sept, LLC Physical Therapist CurrentSince May 20, 2024 Accepting new patients

Locations

2275 Beech Ave
Buena Vista, VA 24416
Phone (540) 466-1000

1516 S Main St
Farmville, VA 23901
Phone (434) 326-0209

1111 Corporate Park Dr
Ste B
Forest, VA 24551
Phone (434) 525-4851

20347 Timberlake Rd
Ste B
Lynchburg, VA 24502
Phone (434) 237-6812

109 Crofton Pl
Palmyra, VA 22963
Phone (434) 589-9588

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, 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": "1600041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712534400000",
    "number": "1649885807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1377 MOTOR PKWY STE 307",
            "city": "ISLANDIA",
            "state": "NY",
            "postal_code": "117495258",
            "telephone_number": "631-580-5200",
            "fax_number": "631-760-8306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 CROFTON PL",
            "city": "PALMYRA",
            "state": "VA",
            "postal_code": "229633300",
            "telephone_number": "434-589-9588",
            "fax_number": "434-589-4096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANNEY",
        "first_name": "JEFFREY",
        "middle_name": "D",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-14",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305213854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmyra, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2024; 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.