Active NPI
Bonnie Jean Middlebrooks, PT
- Physical Therapist
- Chesapeake, VA
National Provider Identifier
1871767681
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2305204441
- Practice address
- 747 Volvo Pkwy
Ste 103
Chesapeake, VA 23320-1615 - Phone
- (757) 420-2880
- Fax
- (757) 420-8090
- NPI assigned
- Apr 14, 2008
- Sex
- Female
- 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 | 2305204441 | VA | Primary |
Addresses
Primary practice location
747 Volvo Pkwy
Ste 103
Chesapeake, VA 23320-1615
Mailing address
747 Volvo Pkwy
Ste 103
Chesapeake, VA 23320-1615
Phone (757) 420-2880
Other identifiers 9
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 57767 | Other | VA | OPTIMA HEALTH INS |
| 193561 | Other | VA | HEALTHKEEPERS |
| 193561 | Other | VA | ANTHEM |
| 2166605 | Other | VA | ALLIANCE HMO,EC,MC |
| 2166605 | Other | VA | MAMSI/OPT/MDIPA/ALLIANCE |
| 1820904006 | Other | VA | UNITED HEALTHCARE |
| 592523 | Other | VA | AETNA |
| 2138099 | Other | VA | FIRST HEALTH |
| 2166605 | Other | VA | ALLIANCE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2305204441 | VA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1208131200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1226620800000",
"number": "1871767681",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "747 VOLVO PKWY",
"address_2": "STE 103",
"city": "CHESAPEAKE",
"state": "VA",
"postal_code": "233201615",
"telephone_number": "757-420-2880",
"fax_number": "757-420-8090"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "747 VOLVO PKWY",
"address_2": "STE 103",
"city": "CHESAPEAKE",
"state": "VA",
"postal_code": "233201615",
"telephone_number": "757-420-2880",
"fax_number": "757-420-8090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIDDLEBROOKS",
"first_name": "BONNIE",
"middle_name": "JEAN",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-04-14",
"last_updated": "2008-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "VA",
"license": "2305204441",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OPTIMA HEALTH INS",
"identifier": "57767",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHKEEPERS",
"identifier": "193561",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "193561",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ALLIANCE HMO,EC,MC",
"identifier": "2166605",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAMSI/OPT/MDIPA/ALLIANCE",
"identifier": "2166605",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "1820904006",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "592523",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST HEALTH",
"identifier": "2138099",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ALLIANCE",
"identifier": "2166605",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chesapeake, VA
- Mid-Atlantic Homecare
- Mid-Atlantic Womens Care PLC
- Mid-Atlantic Womens Care PLC (Virginia Center for Women)
- Mid-Atlantic Womens Care PLC
- Mid-Atlantic Womens Care PLC (TotalCare for Women)
- Renee Gavrish Midgett, PT, DPT
- Toni Midgett, LMT
- Brian Paul Midgette, DDS
- James Midkiff
- William Marvin Midkiff, DDS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.