Individual provider Active NPI

Garrett Charles Van Nutt, DPT

  • Physical Therapist
  • Vinton, VA
National Provider Identifier
1790344844
Registry record updated Jun 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305212857 Issued in VA
Practice address
1110 Vinyard Rd
Vinton, VA 24179-3632
Phone
(540) 343-0466
Fax
(540) 345-2261
NPI assigned
Jun 12, 2019
Last updated
Jun 12, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2019

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 2305212857 VA Primary

Addresses

Primary practice location

1110 Vinyard Rd
Vinton, VA 24179-3632

Mailing address

1110 Vinyard Rd
Vinton, VA 24179-3632
Phone (540) 343-0466

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2305202857VAMDPhysical Therapist
2305212857VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Therapies of Roanoke, Inc. CurrentSince Aug 1, 2021 Accepting new patients
Professional Therapies of Roanoke, Inc. Physical Therapist CurrentSince Aug 1, 2021 Accepting new patients
Functional Pathways Preferred of Tennessee LLC Physical Therapist CurrentSince Dec 31, 2024 Accepting new patients
Ridge Injury & Neuro Rehab, LLC Current Accepting new patients
Professional Therapies of Roanoke, Inc. Past Accepting new patients

Locations

10133 Sherrill Blvd
Ste 200
Knoxville, TN 37932
Phone (865) 392-2849

21371 Forsythe Rd
Bristol, VA 24202
Phone (276) 209-6609

1410 N Augusta St
#A
Staunton, VA 24401

1110 Vinyard Rd
Vinton, VA 24179
Phone (540) 343-0466

3317 Ocean Shore Ave
Virginia Beach, VA 23451
Phone (757) 232-3179

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1560297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560297600000",
    "number": "1790344844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 VINYARD RD",
            "city": "VINTON",
            "state": "VA",
            "postal_code": "241793632",
            "telephone_number": "540-343-0466",
            "fax_number": "540-345-2261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 VINYARD RD",
            "city": "VINTON",
            "state": "VA",
            "postal_code": "241793632",
            "telephone_number": "540-343-0466",
            "fax_number": "540-345-2261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN NUTT",
        "first_name": "GARRETT",
        "middle_name": "CHARLES",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-12",
        "last_updated": "2019-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305212857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vinton, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2019; 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.