Daniel Wallace List, M.S.P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2305202065 Issued in VA

Practice address

9017 Forest Hill Ave Suite 2B
James River Physical Therapy
N. Chestfield, VA 23235

Phone

(804) 330-0936

Fax

(804) 330-0937

NPI assigned

Jun 23, 2005

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

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

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• James River Physical Therapy Inc

  • Physical Therapist
  • Richmond, VA
  • NPI 1568491744
  Medicare reassignment NPD Authorized official
• Advanced Arthritis and Rheumatology Care, PC

  • Rheumatology Physician
  • Midlothian, VA
  • NPI 1922366012
  NPD (past)
• Wellness First, Incorporated

  • Chiropractor
  • Powhatan, VA
  • NPI 1609944792
  NPD (past)

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

{
    "created_epoch": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1750387809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9017 FOREST HILL AVE SUITE 2B",
            "address_2": "JAMES RIVER PHYSICAL THERAPY",
            "city": "N. CHESTERFIELD",
            "state": "VA",
            "postal_code": "23235",
            "telephone_number": "804-330-0936",
            "fax_number": "804-330-0937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9017 FOREST HILL AVE SUITE 2B",
            "address_2": "JAMES RIVER PHYSICAL THERAPY",
            "city": "N. CHESTFIELD",
            "state": "VA",
            "postal_code": "23235",
            "telephone_number": "804-330-0936",
            "fax_number": "804-330-0937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIST",
        "first_name": "DANIEL",
        "middle_name": "WALLACE",
        "name_prefix": "Mr.",
        "credential": "M.S.P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-23",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305202065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• 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.