Individual provider Active NPI

Fionn Gersley

  • Physical Therapy Assistant
  • Virginia Beach, VA
National Provider Identifier
1689406852
Registry record updated Aug 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2306606128 Issued in VA
Practice address
1921 Maple Shade Dr
Virginia Beach, VA 23453-6689
Phone
(757) 329-2902
NPI assigned
Aug 16, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 16, 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 2306606128 VA Primary

Addresses

Primary practice location

1921 Maple Shade Dr
Virginia Beach, VA 23453-6689

Mailing address

5628 Morris Neck Rd
Virginia Beach, VA 23457-1300
Phone (951) 795-5768

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
2306606128VAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy on the Move CurrentSince Aug 18, 2024 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1723766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723766400000",
    "number": "1689406852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5628 MORRIS NECK RD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234571300",
            "telephone_number": "951-795-5768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1921 MAPLE SHADE DR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234536689",
            "telephone_number": "757-329-2902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERSLEY",
        "first_name": "FIONN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-08-16",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "VA",
            "license": "2306606128",
            "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 Aug 16, 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.