Active NPI
Paul T Eckerd, PT CERT MDT
- Physical Therapist
- Midlothian, VA
National Provider Identifier
1952364879
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2305204538
- Practice address
- 6049 Harbour Park Drive
Midlothian, VA 23112 - Phone
- (804) 639-2359
- Fax
- (804) 639-2029
- NPI assigned
- Apr 11, 2006
- Last updated
- Apr 22, 2008
- 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 | 2305204538 | VA | Primary |
Addresses
Primary practice location
6049 Harbour Park Drive
Midlothian, VA 23112
Mailing address
771 Pilot House Drive
Newport News, VA 23606
Phone (757) 873-2302
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00393927 | Other | VA | MEDICARE RAILROAD |
| 010245605 | Medicaid | VA | |
| 192944 | Other | VA | BCBS PHYSICAL THERAPY |
| 7212774 | Other | VA | AETNA |
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 |
|---|---|---|---|
| 2305204538 | VA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144713600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208822400000",
"number": "1952364879",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "771 PILOT HOUSE DRIVE",
"city": "NEWPORT NEWS",
"state": "VA",
"postal_code": "23606",
"telephone_number": "757-873-2302",
"fax_number": "757-873-2306"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6049 HARBOUR PARK DRIVE",
"city": "MIDLOTHIAN",
"state": "VA",
"postal_code": "23112",
"telephone_number": "804-639-2359",
"fax_number": "804-639-2029"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ECKERD",
"first_name": "PAUL",
"middle_name": "T",
"name_prefix": "Mr.",
"credential": "PT CERT MDT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-11",
"last_updated": "2008-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "VA",
"license": "2305204538",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "P00393927",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "010245605",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PHYSICAL THERAPY",
"identifier": "192944",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7212774",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Midlothian, VA
- Earnest Foot and Ankle Specialists PLC
- Russell David Earnest Jr., DPM
- Kathryn Easley, M.S., CF-SLP
- Virginia N East, DDS
- Laura Lopez Eastman, MSN, FNP
- Ramonia Archiretia Eddleton, DDS
- Anne Duval Edge, LCSW
- Jamieson Edmonds, DPT
- David Gwaltney Edmondson, DDS
- Nicole Natalie Edwards-Hamilton, DNP PMHNP-BC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 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.