Individual provider Active NPI

Lukas Weishaar, DPT

  • Physical Therapist
  • Fort Gregg Adams, VA
National Provider Identifier
1790396679
Registry record updated Jan 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
700 24TH St
Fort Gregg Adams, VA 23801-1716
Phone
(804) 734-9200
Fax
(804) 734-9562
NPI assigned
Aug 13, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2025

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 KY Primary

Addresses

Primary practice location

700 24TH St
Fort Gregg Adams, VA 23801-1716

Mailing address

700 24TH St
Fort Gregg Adams, VA 23801-1716
Phone (804) 734-9200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201119001617 KY Practitioner - Physical Therapist in Private Practice 0648681874 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
008142KYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Agilitas USA Inc Physical Therapist CurrentSince Nov 4, 2020 Accepting new patients
Agilitas USA, Inc Physical Therapist CurrentSince Nov 4, 2020 Accepting new patients
Agilitas USA Inc Past Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

805 Blankenbaker Pkwy
Louisville, KY 40243
Phone (502) 253-0833

4611 Outer Loop
Louisville, KY 40219
Phone (502) 625-6233

Organizations & group practices 3

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": "1597276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737676800000",
    "number": "1790396679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 24TH ST",
            "city": "FORT GREGG ADAMS",
            "state": "VA",
            "postal_code": "238011716",
            "telephone_number": "804-734-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 24TH ST",
            "city": "FORT GREGG ADAMS",
            "state": "VA",
            "postal_code": "238011716",
            "telephone_number": "804-734-9200",
            "fax_number": "804-734-9562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISHAAR",
        "first_name": "LUKAS",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-13",
        "last_updated": "2025-01-24",
        "certification_date": "2025-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Gregg Adams, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.