Individual provider Active NPI

Frank Edward Ivan III, P.T.

  • Physical Therapist
  • Winchester, VA
National Provider Identifier
1730485376
Registry record updated Dec 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305206758 Issued in VA
Practice address
2650 S Pleasant Valley Rd
Winchester, VA 22601-6518
Phone
(540) 228-1941
NPI assigned
Jan 30, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 004477 WV
Physical Therapist 225100000X 2305206758 VA Primary

Addresses

Primary practice location

2650 S Pleasant Valley Rd
Winchester, VA 22601-6518

Mailing address

296 Big Timber Rd
Capon Bridge, WV 26711-8943
Phone (304) 860-5366

Other practice location 1

13857 Apple Harvest Dr
Martinsburg, WV 25403-6199
Phone (681) 248-5384

Other identifiers 2

IdentifierTypeStateIssuer
K949 - 0077OtherVACAREFIRST
2307001197OtherVADIRECT ACCESS CERTIFICATION

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC, WV3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20110519000565 VA Practitioner - Physical Therapist in Private Practice 3870779267 Reassigns benefits to 3 organizations
I20201117001558 DC Practitioner - Physical Therapist in Private Practice 3870779267 Reassigns benefits to 2 organizations
I20230918003245 WV Practitioner - Physical Therapist in Private Practice 3870779267 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Professional Sportscare and Rehab LLCGroup PAC ID 9335137363, 103 clinicians
Tidewater Physical Therapy LLCGroup PAC ID 6406759281, 225 clinicians

Practice addresses (Care Compare)

11662 Sudley Manor Dr
50B
Manassas, VA 20109-2842
Phone (571) 321-5720

2650 S Pleasant Valley Rd
Winchester, VA 22601-6518
Phone (540) 228-1941

Merit-based Incentive Payment System (MIPS)

Final score
88.48 of 100Reported as group
Quality
86.04
Promoting interoperability
99
Improvement activities
40
Cost
76.38

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
004477WVMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Powerback Rehabilitation LLC Physical Therapist CurrentSince Sep 1, 2023 Accepting new patients
Fox Rehabilitation Services LLC Physical Therapist CurrentSince Nov 1, 2020 Accepting new patients
Tidewater Physical Therapy, LLC Physical Therapist CurrentSince Apr 1, 2026 Accepting new patients
Professional Sportscare & Rehab, LLC Physical Therapist CurrentSince Sep 5, 2024 Accepting new patients
Powerback Rehabilitation LLC Physical Therapist CurrentSince Sep 1, 2023 Accepting new patients
Tidewater Physical Therapy, LLC Physical Therapist CurrentSince Apr 1, 2026 Accepting new patients
Professional Sportscare & Rehab, LLC Physical Therapist Past Accepting new patients
Alliance Rehabilitation, LLC Physical Therapist Past Accepting new patients
Oracle Heart & Vascular, Inc. PastSince Mar 1, 2025 Accepting new patients

Locations

2122 York Rd
Ste 300
Oak Brook, IL 60523
Phone (630) 575-6250

101 E State St
Kennett Square, PA 19348
Phone (610) 925-4436

1600 Wilson Blvd
Ste 102
Arlington, VA 22209
Phone (301) 464-4500

11662 Sudley Manor Dr
#50B
Manassas, VA 20109
Phone (571) 321-5720

20 E Piccadilly St
Ste 1114
Winchester, VA 22601

2650 S Pleasant Valley Rd
Winchester, VA 22601
Phone (540) 228-1941

13857 Apple Harvest Dr
Martinsburg, WV 25403
Phone (304) 267-8604

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DFHEAD

Organizations & group practices 10

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": "1296345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733529600000",
    "number": "1730485376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "296 BIG TIMBER RD",
            "city": "CAPON BRIDGE",
            "state": "WV",
            "postal_code": "267118943",
            "telephone_number": "304-860-5366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 S PLEASANT VALLEY RD",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226016518",
            "telephone_number": "540-228-1941"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13857 Apple Harvest Dr",
            "address_purpose": "LOCATION",
            "city": "Martinsburg",
            "state": "WV",
            "postal_code": "254036199",
            "country_code": "US",
            "telephone_number": "681-248-5384",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IVAN",
        "first_name": "FRANK",
        "middle_name": "EDWARD",
        "name_suffix": "III",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-01-30",
        "last_updated": "2024-12-07",
        "certification_date": "2024-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WV",
            "license": "004477",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305206758",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST",
            "identifier": "K949 - 0077",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DIRECT ACCESS CERTIFICATION",
            "identifier": "2307001197",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winchester, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2024; 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.