Individual provider Active NPI

Nadine Rose Barruga

  • Physical Therapist
  • Virginia Beach, VA
National Provider Identifier
1669258232
Registry record updated Sep 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305214887 Issued in VA
Practice address
4225 Shore Dr
Virginia Beach, VA 23455-2870
Phone
(757) 460-8868
NPI assigned
Sep 7, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2023

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 2305214887 VA Primary

Addresses

Primary practice location

4225 Shore Dr
Virginia Beach, VA 23455-2870

Mailing address

2066 Nicklaus Dr
Suffolk, VA 23435-4104
Phone (760) 954-4696

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

State licenses

LicenseStateTypeSpecialty
2305214887VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Healthcare Services Inc Physical Therapist CurrentSince Sep 11, 2023 Accepting new patients
Legacy Healthcare Services Inc Physical Therapist CurrentSince Sep 11, 2023 Accepting new patients
Legacy Healthcare Services, Inc Physical Therapist CurrentSince Sep 11, 2023 Accepting new patients

Locations

110 Horizon Dr
#310
Raleigh, NC 27615

110 Horizon Dr
Ste 310
Raleigh, NC 27615
Phone (970) 215-3300

3365 Ogden Rd
Roanoke, VA 24018
Phone (540) 682-7500

1853 Old Donation Pkwy
Virginia Beach, VA 23454
Phone (757) 412-1180

Organizations & group practices 3

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": "1694044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694044800000",
    "number": "1669258232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2066 NICKLAUS DR",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234354104",
            "telephone_number": "760-954-4696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4225 SHORE DR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234552870",
            "telephone_number": "757-460-8868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARRUGA",
        "first_name": "NADINE",
        "middle_name": "ROSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-07",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305214887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; 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.