Individual provider Active NPI

Jessilyn Patricia Warr, LPTA

  • Physical Therapy Assistant
  • Roanoke, VA
National Provider Identifier
1679308860
Registry record updated Sep 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2306606264 Issued in VA
Practice address
4435 Pheasant Ridge Rd
Roanoke, VA 24014-5285
Phone
(540) 725-1120
NPI assigned
Sep 5, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2306606264 VA Primary

Addresses

Primary practice location

4435 Pheasant Ridge Rd
Roanoke, VA 24014-5285

Mailing address

50 Graystone Dr
Daleville, VA 24083-2940
Phone (540) 761-6342

Other names 1

  • Jessilyn Patricia Thompson Former name

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2306606264VAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1725494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725494400000",
    "number": "1679308860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 GRAYSTONE DR",
            "city": "DALEVILLE",
            "state": "VA",
            "postal_code": "240832940",
            "telephone_number": "540-761-6342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4435 PHEASANT RIDGE RD",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240145285",
            "telephone_number": "540-725-1120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARR",
        "first_name": "JESSILYN",
        "middle_name": "PATRICIA",
        "credential": "LPTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-05",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "VA",
            "license": "2306606264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSILYN",
            "last_name": "THOMPSON",
            "middle_name": "PATRICIA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Roanoke, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2024; 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.