NPIMap

Organization Active NPI

Direct Performance Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Virginia Beach, VA
National Provider Identifier
1871998278
Registry record updated Oct 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
DIRECT PERFORMANCE PHYSICAL THERAPY, LLC
Practice address
2247 W Great Neck Rd Ste 101
Virginia Beach, VA 23451-1556
Phone
(757) 742-3778
Fax
(757) 585-3787
NPI assigned
Oct 28, 2014
Last updated
Oct 6, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Stephen McKenzieNPI 1801291125
Title
Owner/DPT
Phone
(757) 748-4846

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

2247 W Great Neck Rd Ste 101
Virginia Beach, VA 23451-1556

Mailing address

2247 W Great Neck Rd Ste 101
Virginia Beach, VA 23451-1556
Phone (757) 742-3778

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150310001923 VA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 1951627934 Receives reassigned benefits from 30 practitioners
Practice locations: Virginia Beach, VA; Norfolk, VA

National Provider Directory

National Provider Directory

Locations

1830 Lindsay Ave
Norfolk, VA 23504

1577 General Booth Blvd
Virginia Beach, VA 23454

1577 General Booth Blvd
Ste 101B
Virginia Beach, VA 23454
Phone (757) 632-3819

1832 Kempsville Rd
Virginia Beach, VA 23464
Phone (757) 278-2573

195 S Rosemont Rd
Virginia Beach, VA 23452
Phone (757) 340-5966

3020 Shore Dr
Ste B
Virginia Beach, VA 23451
Phone (619) 977-0670

4554 Virginia Beach Blvd
Ste 970
Virginia Beach, VA 23462
Phone (757) 636-6727

Practitioners & affiliated clinicians

Practitioners 34

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1414454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633478400000",
    "number": "1871998278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2247 W GREAT NECK RD STE 101",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234511556",
            "telephone_number": "757-742-3778",
            "fax_number": "757-585-3787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2247 W GREAT NECK RD STE 101",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234511556",
            "telephone_number": "757-742-3778",
            "fax_number": "757-585-3787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIRECT PERFORMANCE PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-28",
        "last_updated": "2021-10-06",
        "certification_date": "2021-10-06",
        "status": "A",
        "authorized_official_last_name": "MCKENZIE",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "OWNER/DPT",
        "authorized_official_telephone_number": "757-748-4846"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2021; 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.