Active NPI
Victor Paure Myburgh, BS, PT
- Physical Therapist
- Roanoke, VA
National Provider Identifier
1801081054
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2305005863
- Practice address
- 3603 Brambleton Ave
Suite a
Roanoke, VA 24018-3611 - Phone
- (540) 774-9000
- Fax
- (540) 774-6666
- NPI assigned
- Sep 11, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2305005863 | VA | Primary |
Addresses
Primary practice location
3603 Brambleton Ave
Suite a
Roanoke, VA 24018-3611
Mailing address
3603 Brambleton Ave
Suite a
Roanoke, VA 24018-3611
Phone (540) 774-9000
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)
- Not enrolled
- Credentials
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2305005863 | VA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1189468800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1189468800000",
"number": "1801081054",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3603 BRAMBLETON AVE",
"address_2": "SUITE A",
"city": "ROANOKE",
"state": "VA",
"postal_code": "240183611",
"telephone_number": "540-774-9000",
"fax_number": "540-774-6666"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3603 BRAMBLETON AVE",
"address_2": "SUITE A",
"city": "ROANOKE",
"state": "VA",
"postal_code": "240183611",
"telephone_number": "540-774-9000",
"fax_number": "540-774-6666"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MYBURGH",
"first_name": "VICTOR",
"middle_name": "PAURE",
"name_prefix": "Mr.",
"credential": "BS, PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-09-11",
"last_updated": "2007-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "VA",
"license": "2305005863",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roanoke, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.