Physiatry-Sports & Family Medicine, LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

License

0101241301 Issued in VA

Legal business name

PHYSIATRY-SPORTS & FAMILY MEDICINE, LLC

Practice address

2147 Old Greenbrier Rd
Suite B
Chesapeake, VA 23320-2635

Phone

(757) 366-0200

NPI assigned

Nov 19, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Travis Lee

Title

President

Phone

(757) 366-0200

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1416355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444953600000",
    "number": "1770980757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15763",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233285763",
            "telephone_number": "757-366-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2147 OLD GREENBRIER RD",
            "address_2": "SUITE B",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233202635",
            "telephone_number": "757-366-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSIATRY-SPORTS & FAMILY MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-19",
        "last_updated": "2015-10-16",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "TRAVIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "757-366-0200",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "VA",
            "license": "0101241301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley M Phillips
• Huben Lindale Phillips, IDC
• Lisa Owens Phillips, MS, OTR/L
• Mario Delano Phillips Jr., IDC
• Martin Wynn Phillips, L.P.C.
• John G Piacenti, DPM
• Frank Joseph Piccioni, D.O.
• Janelle Voight Pickering, DNP, CRNA
• Rajeev Koipurath Pillai, MD
• Tanya Pinckney

• Multi-Specialty Clinic/Center in Chesapeake, VA
• Providers in Chesapeake, VA by specialty
• Multi-Specialty Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.