Therapy 360, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2305004961 Issued in VA

Legal business name

THERAPY 360, LLC

Practice address

716 Levy Ave
Charlottesville, VA 22902-5730

Phone

12022574854

Fax

(800) 923-4304

NPI assigned

Jun 28, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Giles Alexander Jackson, PH.D.

Title

Manager

Phone

(202) 257-4854

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nina Jackson, PT

  • Physical Therapist
  • Charlottesville, VA
  • NPI 1063692531
  Medicare reassignment NPD

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

{
    "created_epoch": "1498608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1498608000000",
    "number": "1982125100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "716 LEVY AVE",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229025730",
            "telephone_number": "12022574854",
            "fax_number": "800-923-4304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "716 LEVY AVE",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229025730",
            "telephone_number": "12022574854",
            "fax_number": "800-923-4304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERAPY 360, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-28",
        "last_updated": "2017-06-28",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "GILES",
        "authorized_official_middle_name": "ALEXANDER",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "202-257-4854",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305004961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Performance Place Physical Therapy and Sports Medicine, LLC
• The Seed Collective, LLC
• The Women'S Initiative
• Danny J. Theodore, M.D.
• Alexander Theodores, PT
• Siva Thiagarajah, M.D.
• Eryn Lena Thiele, M.D.
• Robert H Thiele, M.D.
• Gabriella Miggins Thiessen, MD
• Cesarina S Thohan, MD

• Physical Therapist in Charlottesville, VA
• Providers in Charlottesville, VA by specialty
• Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.