Active NPI
Dillon Kephart, DPT
- Physical Therapist
- Chesapeake, VA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2305215000
- Practice address
- 1301 Cedar Rd
Chesapeake, VA 23322-7105 - Phone
- (757) 512-7626
- NPI assigned
- Nov 7, 2022
- Last updated
- Apr 8, 2024
- 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 | 2305215000 | VA | Primary |
Addresses
Primary practice location
1301 Cedar Rd
Chesapeake, VA 23322-7105
Mailing address
PO Box 412307
Boston, MA 02241-2307
Phone (814) 571-0192
Other practice location 1
561 N Airport Dr
Highland Springs, VA 23075-2100
Phone (814) 571-0192
Other practice location 2
905 Battlefield Blvd N Ste 105
Chesapeake, VA 23320-4875
Phone (757) 410-3157
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2305215000 | Other | VA | PHYSICAL THERAPY LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1301 Cedar Rd
Chesapeake, VA 23322-7105
Phone (757) 512-7626
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2305215000 | VA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ivyrehab Sept, LLC | Physical Therapist | Current | Accepting new patients |
| Ivyrehab Sept, LLC | Physical Therapist | Current | Accepting new patients |
Locations
2275 Beech Ave
Buena Vista, VA 24416
Phone (540) 466-1000
1301 Cedar Rd
Chesapeake, VA 23322
Phone (757) 512-7626
905 Battlefield Blvd N
Ste 105
Chesapeake, VA 23320
Phone (757) 410-3157
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Physical Therapist
- Virginia Beach, VA
- NPI 1982657433
-
- Physical Medicine & Rehabilitation Physician
- Verona, VA
- NPI 1235955709
Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1667779200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712534400000",
"number": "1881302081",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 412307",
"city": "BOSTON",
"state": "MA",
"postal_code": "022412307",
"telephone_number": "814-571-0192"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1301 CEDAR RD",
"city": "CHESAPEAKE",
"state": "VA",
"postal_code": "233227105",
"telephone_number": "757-512-7626"
}
],
"practiceLocations": [
{
"address_1": "561 N Airport Dr",
"address_purpose": "LOCATION",
"city": "Highland Springs",
"state": "VA",
"postal_code": "230752100",
"country_code": "US",
"telephone_number": "814-571-0192",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "905 Battlefield Blvd N Ste 105",
"address_purpose": "LOCATION",
"city": "Chesapeake",
"state": "VA",
"postal_code": "233204875",
"country_code": "US",
"telephone_number": "757-410-3157",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KEPHART",
"first_name": "DILLON",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-11-07",
"last_updated": "2024-04-08",
"certification_date": "2024-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "VA",
"license": "2305215000",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHYSICAL THERAPY LICENSE",
"identifier": "2305215000",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Chesapeake, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2024; 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.