Active NPI
Lilla B Whiteside, P.T.
- Physical Therapist
- Fredericksburg, VA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT16287
- Practice address
- 10518 Spotsylvania Ave Ste 100
Fredericksburg, VA 22408-2693 - Phone
- (540) 710-5341
- NPI assigned
- Jun 10, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT16287 | FL | Primary |
Addresses
Primary practice location
10518 Spotsylvania Ave Ste 100
Fredericksburg, VA 22408-2693
Mailing address
3428 N Roosevelt Blvd
Key West, FL 33040-4224
Phone (305) 295-9797
Other practice location 1
3428 N Roosevelt Blvd
Key West, FL 33040-4224
Phone (305) 295-9797
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Emory University School of Medicine, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
10518 Spotsylvania Ave
Suite 100
Fredericksburg, VA 22408-2693
Phone (540) 710-5341
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT16287 | FL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tidewater Physical Therapy, LLC | Physical Therapist | Current | Accepting new patients |
| Tidewater Physical Therapy, LLC | Physical Therapist | Current | Accepting new patients |
Locations
2122 York Rd
Ste 300
Oak Brook, IL 60523
Phone (630) 575-6250
10518 Spotsylvania Ave
#100
Fredericksburg, VA 22408
Phone (540) 710-5341
10128 W Broad St
Bldg Iii
Glen Allen, VA 23060
Phone (804) 217-9210
Organizations & group practices 2
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.
-
- Physical Therapist
- Glen Allen, VA
- NPI 1457389595
-
- Physical Therapist
- Roanoke, VA
- NPI 1437664356
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149897600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1747785600000",
"number": "1770524498",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3428 N ROOSEVELT BLVD",
"city": "KEY WEST",
"state": "FL",
"postal_code": "330404224",
"telephone_number": "305-295-9797",
"fax_number": "305-295-9796"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10518 SPOTSYLVANIA AVE STE 100",
"city": "FREDERICKSBURG",
"state": "VA",
"postal_code": "224082693",
"telephone_number": "540-710-5341"
}
],
"practiceLocations": [
{
"address_1": "3428 N Roosevelt Blvd",
"address_purpose": "LOCATION",
"city": "Key West",
"state": "FL",
"postal_code": "330404224",
"country_code": "US",
"telephone_number": "305-295-9797",
"fax_number": "305-295-9796",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WHITESIDE",
"first_name": "LILLA",
"middle_name": "B",
"credential": "P.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-06-10",
"last_updated": "2025-05-21",
"certification_date": "2025-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT16287",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fredericksburg, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2025; 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.