Individual provider Active NPI

Kimberly Suzanne Brunt, LPTA

  • Physical Therapy Assistant
  • Virginia Beach, VA
National Provider Identifier
1902060890
Registry record updated Jul 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2306000395 Issued in VA
Practice address
1200 Atlantic Shores Drive
Seaside Healthcare Center at Atlantic Shores
Virginia Beach, VA 23454
Phone
(757) 716-2150
Fax
(757) 716-2027
NPI assigned
Jul 10, 2008
Last updated
Jul 10, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2306000395 VA Primary

Addresses

Primary practice location

1200 Atlantic Shores Drive
Seaside Healthcare Center at Atlantic Shores
Virginia Beach, VA 23454

Mailing address

540 Aberthaw Ave
Virginia Health Rehabilitation Agency LLC
Newport News, VA 23601
Phone (757) 595-1946

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

State licenses

LicenseStateTypeSpecialty
2306000395VAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1215648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215648000000",
    "number": "1902060890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 ABERTHAW AVE",
            "address_2": "VIRGINIA HEALTH REHABILITATION AGENCY LLC",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "23601",
            "telephone_number": "757-595-1946",
            "fax_number": "757-595-3238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 ATLANTIC SHORES DRIVE",
            "address_2": "SEASIDE HEALTHCARE CENTER AT ATLANTIC SHORES",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "23454",
            "telephone_number": "757-716-2150",
            "fax_number": "757-716-2027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNT",
        "first_name": "KIMBERLY",
        "middle_name": "SUZANNE",
        "name_prefix": "Miss",
        "credential": "LPTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-10",
        "last_updated": "2008-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "VA",
            "license": "2306000395",
            "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 Jul 10, 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.

Verify at the official NPI Registry.