Active NPI
Ian J Stevenson
- Physical Therapist
- Galax, VA
National Provider Identifier
1942585229
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2305210187
- Practice address
- 106 W Stuart Dr
Galax, VA 24333-2114 - Phone
- (276) 238-8900
- NPI assigned
- Oct 18, 2011
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2305210187 | VA | Primary |
| Physical Therapist | 225100000X | 23826 | MD |
Addresses
Primary practice location
106 W Stuart Dr
Galax, VA 24333-2114
Mailing address
106 W Stuart Dr
Galax, VA 24333-2114
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 |
|---|---|---|---|
| 2305210187 | VA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1318896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1480550400000",
"number": "1942585229",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "106 W STUART DR",
"city": "GALAX",
"state": "VA",
"postal_code": "243332114"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "106 W STUART DR",
"city": "GALAX",
"state": "VA",
"postal_code": "243332114",
"telephone_number": "276-238-8900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEVENSON",
"first_name": "IAN",
"middle_name": "J",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-10-18",
"last_updated": "2016-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "VA",
"license": "2305210187",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MD",
"license": "23826",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Galax, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.