Maria Petronila Tibung, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2305206548 Issued in VA

Practice address

1202 Redbud Rd
Blacksburg, VA 24060-1714

Phone

(540) 425-6033

NPI assigned

Oct 30, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Core Physical Therapy LLCGroup PAC ID 3173800794, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Core Physical Therapy LLC

  • Physical Therapy Clinic/Center
  • Blacksburg, VA
  • NPI 1356798565
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1414627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414627200000",
    "number": "1689079766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 REDBUD RD",
            "city": "BLACKSBURG",
            "state": "VA",
            "postal_code": "240601714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 REDBUD RD",
            "city": "BLACKSBURG",
            "state": "VA",
            "postal_code": "240601714",
            "telephone_number": "540-425-6033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIBUNG",
        "first_name": "MARIA PETRONILA",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-30",
        "last_updated": "2014-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305206548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chad Randal Thompson, MD
• Christel Thompson, M.A., CCC/SLP
• Damon Bennett Thompson, D.D.S.
• Daniel E Thompson, DDS
• Morgan Thomson
• Tidewater Physical Therapy, LLC
• Hannah Tiller, BCBA, LBA
• James Tillett
• Tilley Chiropractic and Sports Injury Clinic
• Alina H Tobey, DO

• Physical Therapist in Blacksburg, VA
• Providers in Blacksburg, VA by specialty
• Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2014; 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.