NPIMap

Organization Active NPI

Virginia Health Rehabilitation Agency, LLC

  • Physical Therapist
  • Newport News, VA
National Provider Identifier
1972686780
Registry record updated Aug 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
VIRGINIA HEALTH REHABILITATION AGENCY, LLC
Practice address
1101 William Styron SQ S
Newport News, VA 23606
Phone
(757) 594-0330
Fax
(757) 594-0332
NPI assigned
Oct 23, 2006
Last updated
Aug 28, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2020

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

Authorized official

Name
Mrs. Nicole L Boldy
Title
Cfo
Phone
(757) 599-7422

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary
Occupational Therapist 225X00000X NU
Speech-Language Pathologist 235Z00000X NU

Addresses

Primary practice location

1101 William Styron SQ S
Newport News, VA 23606

Mailing address

240 Nat Turner Blvd S
Newport News, VA 23606-0020
Phone (757) 595-1946

Other identifiers 4

IdentifierTypeStateIssuer
190035OtherVAANTHEM OCCUPATIONAL THERA
190031OtherVAANTHEM SPEECH THERAPY
190034OtherVAANTHEM PHYSICAL THERAPY
004981103MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20021226000010 VA Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 6901714021 Practice locations: Newport News, VA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1972686780. Details of each certification follow.

  • CCN 496676 Outpatient physical therapy / speech pathology · Active · Name & address match · Details

Outpatient physical therapy / speech pathology certification: CCN 496676

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
VIRGINIA HEALTH REHABILITATION
Certification status
Active
Provider type (POS)
Outpatient physical therapy / speech pathology
Participating since
Jul 25, 2001
Last certification
May 23, 2024
Ownership / control type
Proprietary
Facility address
1101 William Styron SQ South
Newport News, VA 23606

National Provider Directory

National Provider Directory

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1101 William Styron Sq S
Newport News, VA 23606
Phone (757) 594-0330

204 Nat Turner Blvd S
Newport News, VA 23606
Phone (757) 223-1396

Ownership & related parties

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Atlantic View Post AcuteNewport News, VA, CCN 495286 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Sep 10, 2025
Sep 8, 2025
Newport Post AcuteNewport News, VA, CCN 495368 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Sep 10, 2025
Sep 8, 2025
Langley Post AcuteHampton, VA, CCN 495367 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Sep 10, 2025
Sep 10, 2025
York Post AcuteYorktown, VA, CCN 495342 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Sep 10, 2025
Sep 2, 2025

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598572800000",
    "number": "1972686780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 NAT TURNER BLVD S",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236060020",
            "telephone_number": "757-595-1946",
            "fax_number": "757-596-3621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 WILLIAM STYRON SQ S",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "23606",
            "telephone_number": "757-594-0330",
            "fax_number": "757-594-0332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIRGINIA HEALTH REHABILITATION AGENCY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2020-08-28",
        "certification_date": "2020-08-28",
        "status": "A",
        "authorized_official_last_name": "BOLDY",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "757-599-7422",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM OCCUPATIONAL THERA",
            "identifier": "190035",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM SPEECH THERAPY",
            "identifier": "190031",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PHYSICAL THERAPY",
            "identifier": "190034",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004981103",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

Verify at the official NPI Registry.