Phyllis Grimmer Eberline, PT,DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2305000880 Issued in VA

Practice address

900 South Church Lane
Tappahannock, VA 22560

Phone

(804) 443-4850

Fax

(804) 443-4851

NPI assigned

Jun 13, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Essex Physical Therapy, Inc.Group PAC ID 2567484595, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Essex Physical Therapy, Inc.

  • Physical Therapist
  • Tappahannock, VA
  • NPI 1841314440
  Medicare reassignment Care Compare group NPD
• Belfield Physical Therapy Inc

  • Physical Therapist
  • Warsaw, VA
  • NPI 1215994058
  Medicare reassignment NPD
• King William Physical Therapy

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Aylett, VA
  • NPI 1508049255
  Medicare reassignment NPD
• The Audiology Offices LLC

  • Audiologist
  • Kilmarnock, VA
  • NPI 1972716066
  NPD (past)

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

{
    "created_epoch": "1339545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430956800000",
    "number": "1699037804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1401",
            "city": "TAPPAHANNOCK",
            "state": "VA",
            "postal_code": "225601401",
            "telephone_number": "804-443-4850",
            "fax_number": "804-443-4851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 SOUTH CHURCH LANE",
            "city": "TAPPAHANNOCK",
            "state": "VA",
            "postal_code": "22560",
            "telephone_number": "804-443-4850",
            "fax_number": "804-443-4851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBERLINE",
        "first_name": "PHYLLIS",
        "middle_name": "GRIMMER",
        "credential": "PT,DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-13",
        "last_updated": "2015-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305000880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1699037804",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA STATE LICENSE",
            "identifier": "2305000880",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE P-TAN",
            "identifier": "C09695",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Comprehensive Eyecare of Virginia
• Cornerstone Behavioral Health Solutions, LLC
• Bonnie Deschner, MD
• James Flinn Donecker, M.D.
• Tracy A Dzibela, O.D.
• Thomas Amos Elliott
• Kwame Binfo Ennin, PHARMD
• Rosemary Theresa Enright, M.D.
• Essex County EMS
• Essex County Public Schools

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2015; 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.