Organization Active NPI

Smithfield Physical Therapy Specialists, LLC

  • Physical Therapist
  • Smithfield, VA
National Provider Identifier
1740934199
Registry record updated Feb 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
SMITHFIELD PHYSICAL THERAPY SPECIALISTS, LLC
Practice address
103 Beale Ave
Smithfield, VA 23430-1403
Phone
(540) 598-3960
NPI assigned
Feb 4, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2022

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

Authorized official

Name
Dr. Samuel Joseph Bikkers Jr., PT, DPTNPI 1265941728
Title
Owner
Phone
(540) 598-3960

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

103 Beale Ave
Smithfield, VA 23430-1403

Mailing address

103 Beale Ave
Smithfield, VA 23430-1403
Phone (540) 598-3960

Other identifiers 1

IdentifierTypeStateIssuer
1265941728MedicaidVA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220826002261 VA Part B Supplier - Clinic/Group Practice 7719361674 Receives reassigned benefits from 2 practitioners
Practice locations: Smithfield, VA

National Provider Directory

National Provider Directory

Locations

319 Main St
Ste 110
Smithfield, VA 23430
Phone (757) 644-1063

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1643932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644192000000",
    "number": "1740934199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 BEALE AVE",
            "city": "SMITHFIELD",
            "state": "VA",
            "postal_code": "234301403",
            "telephone_number": "540-598-3960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 BEALE AVE",
            "city": "SMITHFIELD",
            "state": "VA",
            "postal_code": "234301403",
            "telephone_number": "540-598-3960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMITHFIELD PHYSICAL THERAPY SPECIALISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-04",
        "last_updated": "2022-02-07",
        "certification_date": "2022-02-07",
        "status": "A",
        "authorized_official_last_name": "BIKKERS",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "540-598-3960",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1265941728",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithfield, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.