The Source Pelvic Health and Wellness LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

THE SOURCE PELVIC HEALTH AND WELLNESS LLC

Practice address

2380 Liberty Way Ste 2
Virginia Beach, VA 23456-3466

Phone

(757) 932-8977

Fax

(757) 932-8979

NPI assigned

Jun 24, 2024

Organization subpart

No

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

Authorized official

Name

Kimberly A NaylorNPI 1205035326

Title

Co-Owner

Phone

(757) 572-5757

Specialties & licenses 1

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kimberly Ann Naylor, PT

  • Physical Therapist
  • VA Beach, VA
  • NPI 1205035326
  NPD Authorized official
• Shirley Kent, DPT

  • Physical Therapist
  • Virginia Beach, VA
  • NPI 1821420860
  NPD
• Jaclyn Napier, DPT

  • Physical Therapist
  • Virginia Beach, VA
  • NPI 1336386184
  NPD

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

{
    "created_epoch": "1719187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719187200000",
    "number": "1689418550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2380 LIBERTY WAY STE 2",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234563466",
            "telephone_number": "757-932-8977",
            "fax_number": "757-932-8979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2380 LIBERTY WAY STE 2",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234563466",
            "telephone_number": "757-932-8977",
            "fax_number": "757-932-8979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE SOURCE PELVIC HEALTH AND WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-24",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A",
        "authorized_official_last_name": "NAYLOR",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "757-572-5757"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Clinic/Center in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Physical Therapy Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 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.