Individual provider Active NPI

Bernard Zachary Poelker, DPT

  • Physical Therapist
  • Chesapeake, VA
National Provider Identifier
1952179210
Registry record updated Dec 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305215389 Issued in VA
Practice address
715 Argyll St
Chesapeake, VA 23320-3105
Phone
(757) 547-4528
NPI assigned
Dec 18, 2023
Last updated
Dec 18, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2305215389 VA Primary

Addresses

Primary practice location

715 Argyll St
Chesapeake, VA 23320-3105

Mailing address

655 S Willow St Ste 128
Manchester, NH 03103-5723
Phone (800) 995-2673

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
2305215389VAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1702857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702857600000",
    "number": "1952179210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 S WILLOW ST STE 128",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031035723",
            "telephone_number": "800-995-2673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 ARGYLL ST",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233203105",
            "telephone_number": "757-547-4528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POELKER",
        "first_name": "BERNARD",
        "middle_name": "ZACHARY",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-12-18",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305215389",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Dec 18, 2023; 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.