NPIMap

Organization Active NPI

Physiatry-Sports & Family Medicine, LLC

  • Multi-Specialty Clinic/Center
  • Chesapeake, VA
National Provider Identifier
1770980757
Registry record updated Oct 16, 2015
On this page

Key facts

NPPES NPI Registry
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
Last updated
Oct 16, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2015

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

Authorized official

Name
Dr. Travis LeeNPI 1376732628
Title
President
Phone
(757) 366-0200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X 0101241301 VA Primary

Addresses

Primary practice location

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

Mailing address

PO Box 15763
Chesapeake, VA 23328-5763
Phone (757) 366-0200

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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": []
}

Other providers in Chesapeake, VA

Sources for this page

  • 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.