Individual provider Active NPI

Patrick Thomas Harvey Jr., PT, DPT

  • Physical Therapist
  • Chester, VA
National Provider Identifier
1679109813
Registry record updated Mar 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305211323 Issued in VA
Practice address
12212 Branders Creek Dr
Chester, VA 23831-1626
Phone
(804) 425-4545
Fax
(804) 425-4546
NPI assigned
Mar 19, 2020
Last updated
Mar 19, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 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 2305211323 VA Primary

Addresses

Primary practice location

12212 Branders Creek Dr
Chester, VA 23831-1626

Mailing address

12212 Branders Creek Dr
Chester, VA 23831-1626
Phone (804) 425-4545

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230222001129 VA Practitioner - Physical Therapist in Private Practice 1456724475 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Virginia Commonwealth University, School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mike Kelo Physical Therapy PLLCGroup PAC ID 9436214160, 2 clinicians

Practice addresses (Care Compare)

12212 Branders Creek Dr
Chester, VA 23831-1626
Phone (804) 425-4545

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2305211323VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mike Kelo Physical Therapy, PLLC Physical Therapist CurrentSince Jan 19, 2023 Accepting new patients

Locations

12212 Branders Creek Dr
Chester, VA 23831
Phone (804) 366-8518

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": "1584576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584576000000",
    "number": "1679109813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12212 BRANDERS CREEK DR",
            "city": "CHESTER",
            "state": "VA",
            "postal_code": "238311626",
            "telephone_number": "804-425-4545",
            "fax_number": "804-425-4546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12212 BRANDERS CREEK DR",
            "city": "CHESTER",
            "state": "VA",
            "postal_code": "238311626",
            "telephone_number": "804-425-4545",
            "fax_number": "804-425-4546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARVEY",
        "first_name": "PATRICK",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-19",
        "last_updated": "2020-03-19",
        "certification_date": "2020-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305211323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chester, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 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.