Individual provider Active NPI

Lucas W Johnson, PT, DPT, SCS

  • Orthopedic Physical Therapist
  • Norfolk, VA
National Provider Identifier
1740486950
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
2305205065 Issued in VA
Practice address
6330 Newtown Rd
Suite 100
Norfolk, VA 23502-4802
Phone
(757) 466-4401
Fax
(757) 466-4404
NPI assigned
Jun 25, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 2305205065 VA Primary

Addresses

Primary practice location

6330 Newtown Rd
Suite 100
Norfolk, VA 23502-4802

Mailing address

437 Rhode Island Ave
Norfolk, VA 23508-2141
Phone (703) 216-4290

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080102000255 VA Practitioner - Physical Therapist in Private Practice 2062592173 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atlantic Physical Therapy PCGroup PAC ID 9931208683, 4 clinicians

Practice addresses (Care Compare)

1016 1St Colonial Rd
Virginia Beach, VA 23454-3073
Phone (757) 481-4066

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Atlantic Physical Therapy PC Orthopedic CurrentSince Jun 4, 2007 Accepting new patients

Locations

6330 Newtown Rd
Ste 100
Norfolk, VA 23502
Phone (757) 466-4401

1016 First Colonial Rd
Virginia Beach, VA 23454
Phone (757) 481-4066

Organizations & group practices 1

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": "1182729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1740486950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "437 RHODE ISLAND AVE",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235082141",
            "telephone_number": "703-216-4290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6330 NEWTOWN RD",
            "address_2": "SUITE 100",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235024802",
            "telephone_number": "757-466-4401",
            "fax_number": "757-466-4404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "LUCAS",
        "middle_name": "W",
        "credential": "PT, DPT, SCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-25",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "VA",
            "license": "2305205065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.