Athletic Edge Physical Therapy PLLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

ATHLETIC EDGE PHYSICAL THERAPY PLLC

Practice address

5859 Ginger Dr
Providence Forge, VA 23140-3585

Phone

(757) 634-9256

NPI assigned

Nov 21, 2025

Last updated

Nov 21, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Logan EvansNPI 1780373431

Title

Owner

Phone

(757) 634-9256

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Logan Evans, PT, DPT

  • Physical Therapist
  • Roanoke, VA
  • NPI 1780373431
  NPD Authorized official

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

{
    "created_epoch": "1763683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763683200000",
    "number": "1730040312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5859 GINGER DR",
            "city": "PROVIDENCE FORGE",
            "state": "VA",
            "postal_code": "231403585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5859 GINGER DR",
            "city": "PROVIDENCE FORGE",
            "state": "VA",
            "postal_code": "231403585",
            "telephone_number": "757-634-9256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATHLETIC EDGE PHYSICAL THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-21",
        "last_updated": "2025-11-21",
        "certification_date": "2025-11-21",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "LOGAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "757-634-9256"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abdi Home Care Inc.
• Cecil Linwood Allen
• Janice V. Atwell, LCSW
• Avencrest Healthcare Group LLC
• Clarice U. Baugh, RN
• Bay Rivers Nutrition, LLC
• Ankita Bhanderi, PHARM.D

• Physical Therapy Clinic/Center in Providence Forge, VA
• Providers in Providence Forge, 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 Nov 21, 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.