Individual provider Active NPI

Carrie Williams, MSPT

  • Physical Therapist
  • Virginia Beach, VA
National Provider Identifier
1780743716
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305831257 Issued in VA
Practice address
1400 Fordham Dr
Virginia Beach, VA 23464-5368
Phone
(757) 361-3954
NPI assigned
Dec 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2305831257 VA Primary

Addresses

Primary practice location

1400 Fordham Dr
Virginia Beach, VA 23464-5368

Mailing address

4653 Copperfield Rd
Virginia Beach, VA 23455-4858
Phone (757) 464-3680

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230208000485 VA Practitioner - Physical Therapist in Private Practice 4587036173 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Old Dominion UniversityGroup PAC ID 3476770520, 13 clinicians
Cortex Initiative LLCGroup PAC ID 7113441148, 6 clinicians

Practice addresses (Care Compare)

1015 W 47TH St
Norfolk, VA 23529-0001

1019 W
41St
Norfolk, VA 23529-0047
Phone (757) 683-7041

309 Aragona Blvd
Suite 107 108
Virginia Beach, VA 23462-2700
Phone (757) 780-8146

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2305831257VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Old Dominion University Physical Therapist CurrentSince Jan 4, 2023 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780743716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4653 COPPERFIELD RD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234554858",
            "telephone_number": "757-464-3680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 FORDHAM DR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234645368",
            "telephone_number": "757-361-3954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "CARRIE",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305831257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.