Mariah Idul

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2305214983 Issued in VA

Practice address

501 Discovery Dr
Chesapeake, VA 23320-3832

Phone

(757) 547-5145

NPI assigned

Jun 14, 2022

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Sport Medicine and Orthopaedic Center Inc

  • Orthopaedic Surgery Physician
  • Chesapeake, VA
  • NPI 1043246556

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1655164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655164800000",
    "number": "1780314682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4084 CONCORDIA WAY",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234531760",
            "telephone_number": "757-636-5849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 DISCOVERY DR",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233203832",
            "telephone_number": "757-547-5145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IDUL",
        "first_name": "MARIAH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-14",
        "last_updated": "2022-06-14",
        "certification_date": "2022-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305214983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Altovise Lee Hyman, M.A., QMPH-A, CSAC
• Susan Annabelle Hynes
• I-Thrive Therapy and Wellness, LLC
• Joseph Frank Iannone, D.M.D.
• Erin Icenbice, PA
• Eleodora Merle Ignacio, M.D.
• Gordon John Iiams, M.D.
• Ginnie Ileto
• Melhem A Imad, M.D.
• Image House

• Physical Therapist in Chesapeake, VA
• Providers in Chesapeake, VA by specialty
• Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2022; 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.