Phyllis Tacik

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2306601224 Issued in VA

Practice address

928 Diamond Springs Rd Ste 103
Virginia Beach, VA 23455-6601

Phone

(757) 395-1975

Fax

(757) 425-7180

NPI assigned

Dec 17, 2020

Last updated

Dec 17, 2020By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Sentara Hospitals

  dba Sentara Leigh Hospital

  • General Acute Care Hospital
  • Norfolk, VA
  • NPI 1811957681
  NPD (past)

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

{
    "created_epoch": "1608163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608163200000",
    "number": "1720674351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "928 DIAMOND SPRINGS RD STE 103",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234556601",
            "telephone_number": "757-395-1975",
            "fax_number": "757-425-7180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "928 DIAMOND SPRINGS RD STE 103",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234556601",
            "telephone_number": "757-395-1975",
            "fax_number": "757-425-7180"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5660 Indian River Rd Ste 121",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234645240",
            "country_code": "US",
            "telephone_number": "757-252-5300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TACIK",
        "first_name": "PHYLLIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-17",
        "last_updated": "2020-12-17",
        "certification_date": "2020-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "VA",
            "license": "2306601224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• T&Rheart, LLC (Heart2Heart Transportation)
• T2 Fitness
• Jennie Hurwitz Tabakin, M.D.
• Keishawnu Taborn
• Chloe Tabron
• Sarah Tackett, MSED, LPC
• Dorothy T Tadder, FNP
• Diana Y Tagbor
• Suzanne Elizabeth Tagliaferri, PT, DPT
• Adetunji Taiwo

• Physical Therapy Assistant in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Physical Therapy Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2020; 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.