Nicholas Stark, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

CP053748 Issued in VA

Practice address

133 Market Center Way Ste 2
Daleville, VA 24083-3284

Phone

(540) 242-3017

Fax

(540) 492-4058

NPI assigned

Jan 12, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in LA, VA2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ivyrehab Sept, LLCGroup PAC ID 7911990908, 216 clinicians

Baton Rouge Orthopaedic Clinic LLCGroup PAC ID 3274446414, 142 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Baton Rouge Orthopaedic Clinic, LLC

  • Orthopaedic Surgery Physician
  • Baton Rouge, LA
  • NPI 1770503690

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Ivyrehab Sept, LLC

  • Physical Therapist
  • Virginia Beach, VA
  • NPI 1982657433
  Medicare reassignment Care Compare group
• Baton Rouge Orthopaedic Clinic

  • Durable Medical Equipment & Medical Supplies
  • Zachary, LA
  • NPI 1215102033
  NPD

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

{
    "created_epoch": "1641945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787788800000",
    "number": "1740931641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 412307",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022412307",
            "telephone_number": "914-294-4050",
            "fax_number": "631-760-8306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 MARKET CENTER WAY STE 2",
            "city": "DALEVILLE",
            "state": "VA",
            "postal_code": "240833284",
            "telephone_number": "540-242-3017",
            "fax_number": "540-492-4058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARK",
        "first_name": "NICHOLAS",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-12",
        "last_updated": "2026-08-27",
        "certification_date": "2026-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "CP053748",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "10932",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Select Physical Therapy Holdings, Inc.
• Servant Pharmacy of Virginia Inc
• Kayla Marie Spengler, PSY.D.
• Chelsea Sprouse, PHARMD
• Justin Paul St. Charles
• Devin Stewart
• Valerie Stowell, LPC
• Sunshine Doctors
• Randal L Swatzyna, PA
• Cherry Emil Takawi, DDS

• Physical Therapist in Daleville, VA
• Providers in Daleville, VA by specialty
• Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2026; 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.