Calla L. Selfridge, PT, DPT, CMTPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2305206270 Issued in VA

Practice address

204 Gumwood Dr
Smithfield, VA 23430-6087

Phone

(757) 357-7762

Fax

(757) 357-7765

NPI assigned

Oct 22, 2009

Last updated

May 3, 2018By 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

Other names 1

• Calla L. Deruosi Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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.

• Tidewater Physical Therapy LLC

  dba Pivot Physical Therapy of Virginia

  • Physical Therapist
  • Norfolk, VA
  • NPI 1205345444
  NPD (past)
• Tidewater Physical Therapy LLC

  dba Pivot Physical Therapy of Virginia

  • Physical Therapist
  • Fredericksburg, VA
  • NPI 1427561984
  NPD (past)
• Tidewater Physical Therapy LLC

  dba Pivot Physical Therapy of Virginia

  • Physical Therapist
  • Salem, VA
  • NPI 1841700432
  NPD (past)
• Tidewater Physical Therapy, LLC

  dba Pivot Physical Therapy of Virginia

  • Physical Therapist
  • Virginia Beach, VA
  • NPI 1083133268
  NPD (past)
• Tidewater Physical Therapy, LLC

  dba Pantops Physical Therapy

  • Physical Therapist
  • Charlottesville, VA
  • NPI 1932648649
  NPD (past)

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

{
    "created_epoch": "1256169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525305600000",
    "number": "1730415944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 69030",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212649030",
            "telephone_number": "757-873-2302",
            "fax_number": "757-873-2306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 GUMWOOD DR",
            "city": "SMITHFIELD",
            "state": "VA",
            "postal_code": "234306087",
            "telephone_number": "757-357-7762",
            "fax_number": "757-357-7765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELFRIDGE",
        "first_name": "CALLA",
        "middle_name": "L.",
        "credential": "PT, DPT, CMTPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-22",
        "last_updated": "2018-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305206270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CALLA",
            "last_name": "DERUOSI",
            "middle_name": "L.",
            "credential": "PT, DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Riverside Physician Services, Inc (Riverside Hampton Roads Surgical Specialists)
• Riverside Physicians Services Inc (Riverside Urology Specialists Smithfield)
• Sharon Roberts, M.D.
• Sheila D Robinette, LPC
• Stephanie D Royal, LMT
• Justin Walter Seligman, ATC
• Senior 1St Home Healthcare LLC
• Senior 1St Transportation LLC
• Laletha Shabazz, PMHNP
• Rodney Shearn

• Physical Therapist in Smithfield, VA
• Providers in Smithfield, 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 3, 2018; 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.