NPIMap

Organization Active NPI

Southeastern Physical Therapy, Inc

Doing business as Spectrum Physical Therapy

  • Physical Therapist
  • Palmyra, VA
National Provider Identifier
1740407527
Registry record updated May 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
SOUTHEASTERN PHYSICAL THERAPY, INC
Doing business as
Spectrum Physical Therapy
Practice address
100 Crofton PL
Lake Monticello
Palmyra, VA 22963-3300
Phone
(434) 589-9588
Fax
(434) 589-4096
NPI assigned
Apr 20, 2007
Last updated
May 22, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2015

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

Authorized official

Name
Jeff Lowell Hartline, MPTNPI 1093758062
Title
President/Owner
Phone
(757) 467-1900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

100 Crofton PL
Lake Monticello
Palmyra, VA 22963-3300

Mailing address

5301 Providence Rd
Suite 80
Virginia Beach, VA 23464-4128
Phone (757) 467-1900

Other names 1

  • Spectrum Physical Therapy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Southeastern Physical Therapy19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

Organizations that report the same tax identification number in the National Provider Directory.

View all 18

Locations

100 Crofton Pl
Palmyra, VA 22963
Phone (434) 589-4096

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432252800000",
    "number": "1740407527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5301 PROVIDENCE RD",
            "address_2": "SUITE 80",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234644128",
            "telephone_number": "757-467-1900",
            "fax_number": "757-467-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CROFTON PL",
            "address_2": "LAKE MONTICELLO",
            "city": "PALMYRA",
            "state": "VA",
            "postal_code": "229633300",
            "telephone_number": "434-589-9588",
            "fax_number": "434-589-4096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN PHYSICAL THERAPY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-20",
        "last_updated": "2015-05-22",
        "status": "A",
        "authorized_official_last_name": "HARTLINE",
        "authorized_official_first_name": "JEFF",
        "authorized_official_middle_name": "LOWELL",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "757-467-1900",
        "authorized_official_credential": "MPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spectrum Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Palmyra, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2015; 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.