Individual provider Active NPI

Adam Tanner

  • Physical Therapist
  • Richmond, VA
National Provider Identifier
1871174656
Registry record updated Apr 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305213758 Issued in VA
Practice address
3100 W Marshall St
Richmond, VA 23230-4706
Phone
(804) 342-5857
NPI assigned
Apr 14, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2021

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 2305213758 VA Primary

Addresses

Primary practice location

3100 W Marshall St
Richmond, VA 23230-4706

Mailing address

350 New Fidelity CT
Garner, NC 27529-2665
Phone (919) 258-2714

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210609002206 VA Practitioner - Physical Therapist in Private Practice 2264832468 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tidewater Physical Therapy LLCGroup PAC ID 6406759281, 225 clinicians

Practice addresses (Care Compare)

3100 W Marshall St
Richmond, VA 23230-4706
Phone (804) 342-5857

Merit-based Incentive Payment System (MIPS)

Final score
88.16 of 100Reported as group
Quality
85.78
Promoting interoperability
99
Improvement activities
40
Cost
75.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Tidewater Physical Therapy, LLC Physical Therapist CurrentSince Apr 26, 2021 Accepting new patients
Tidewater Physical Therapy, LLC Physical Therapist CurrentSince Apr 26, 2021 Accepting new patients

Locations

350 New Fidelity Ct
Garner, NC 27529
Phone (919) 373-2919

10128 W Broad St
Bldg Iii
Glen Allen, VA 23060
Phone (804) 217-9210

12494 Warwick Blvd
Newport News, VA 23606
Phone (804) 217-9210

3100 W Marshall St
Richmond, VA 23230
Phone (804) 342-5857

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": "1618358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619395200000",
    "number": "1871174656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 NEW FIDELITY CT",
            "city": "GARNER",
            "state": "NC",
            "postal_code": "275292665",
            "telephone_number": "919-258-2714",
            "fax_number": "410-648-4878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 W MARSHALL ST",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232304706",
            "telephone_number": "804-342-5857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANNER",
        "first_name": "ADAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-14",
        "last_updated": "2021-04-26",
        "certification_date": "2021-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305213758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2021; 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.