Individual provider Active NPI

Brandon Wayne Houdashelt, LPTA

  • Physical Therapy Assistant
  • Virginia Beach, VA
National Provider Identifier
1699644211
Registry record updated Nov 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2306606725 Issued in VA
Practice address
5604 Virginia Beach Blvd Ste 101
Virginia Beach, VA 23462-5631
Phone
(757) 455-5000
NPI assigned
Nov 3, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2025

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 2306606725 VA Primary

Addresses

Primary practice location

5604 Virginia Beach Blvd Ste 101
Virginia Beach, VA 23462-5631

Mailing address

5604 Virginia Beach Blvd Ste 101
Virginia Beach, VA 23462-5631
Phone (757) 455-5000

Other practice location 1

21 Enterprise Pkwy Ste 100
Hampton, VA 23666-6418
Phone (757) 455-5000

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
2306606725VAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
JP Therapy, LLC CurrentSince Nov 9, 2025 Accepting new patients

Locations

21 Enterprise Pkwy
Ste 100
Hampton, VA 23666

5604 Virginia Beach Blvd
Ste 101
Virginia Beach, VA 23462

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": "1762128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762128000000",
    "number": "1699644211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5604 VIRGINIA BEACH BLVD STE 101",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234625631",
            "telephone_number": "757-455-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5604 VIRGINIA BEACH BLVD STE 101",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234625631",
            "telephone_number": "757-455-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21 Enterprise Pkwy Ste 100",
            "address_purpose": "LOCATION",
            "city": "Hampton",
            "state": "VA",
            "postal_code": "236666418",
            "country_code": "US",
            "telephone_number": "757-455-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOUDASHELT",
        "first_name": "BRANDON",
        "middle_name": "WAYNE",
        "credential": "LPTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-11-03",
        "last_updated": "2025-11-03",
        "certification_date": "2025-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "VA",
            "license": "2306606725",
            "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 Nov 3, 2025; 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.