Individual provider Active NPI

Teri L. Draper, PT, DPT

  • Physical Therapist
  • Glen Allen, VA
National Provider Identifier
1992221816
Registry record updated Oct 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P24209 Issued in NC
Practice address
10128 W Broad St BLDG III
Glen Allen, VA 23060-6761
Phone
(804) 217-9210
Fax
(804) 217-9213
NPI assigned
Aug 22, 2017
Last updated
Oct 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X P24209 NC Primary
Physical Therapist 225100000X 2305211304 VA

Addresses

Primary practice location

10128 W Broad St BLDG III
Glen Allen, VA 23060-6761

Mailing address

PO Box 412313
Boston, MA 02241-2313

Other practice location 1

210 Beatty Dr Ste 220
Belmont, NC 28012-2716
Phone (704) 500-0876

Other identifiers 1

IdentifierTypeStateIssuer
C05954OtherVAMEDICARE GROUP PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20171120000024 VA Practitioner - Physical Therapist in Private Practice 0042576431 Reassigns benefits to 1 organization
I20251106005244 NC Practitioner - Physical Therapist in Private Practice 0042576431 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Virginia Commonwealth University, School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ivyrehab North Carolina LLCGroup PAC ID 8820336324, 158 clinicians

Practice addresses (Care Compare)

210 Beatty Dr
Suite 220
Belmont, NC 28012-2716
Phone (704) 500-0876

Merit-based Incentive Payment System (MIPS)

Final score
88.16 of 100Reported as group
Quality
85.78
Promoting interoperability
99
Improvement activities
40
Cost
75.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P24209NCMDPhysical Therapist
2305211304VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Tidewater Physical Therapy, LLC Physical Therapist CurrentSince Aug 31, 2017 Accepting new patients
Tidewater Physical Therapy, LLC Physical Therapist CurrentSince Aug 31, 2017 Accepting new patients
Ivyrehab North Carolina LLC CurrentSince Sep 22, 2025 Accepting new patients
Ivyrehab North Carolina LLC Physical Therapist CurrentSince Sep 22, 2025 Accepting new patients
Tidewater Physical Therapy, LLC Physical Therapist Past Accepting new patients
Tidewater Physical Therapy LLC Physical Therapist Past Accepting new patients
Tidewater Physical Therapy LLC Physical Therapist Past Accepting new patients
Tidewater Physical Therapy LLC Physical Therapist Past Accepting new patients
Tidewater Physical Therapy LLC Physical Therapist Past Accepting new patients
Tidewater Physical Therapy, LLC Physical Therapist Past Accepting new patients

Locations

210 Beatty Dr
#220
Belmont, NC 28012

210 Beatty Dr
Ste 220
Belmont, NC 28012
Phone (704) 500-0876

5960 Fairview Rd
Ste 250
Charlotte, NC 28210
Phone (980) 224-7958

9216 Ardrey Kell Rd
Ste 300
Charlotte, NC 28277
Phone (980) 556-7330

10128 W Broad St
Bldg Iii
Glen Allen, VA 23060
Phone (804) 217-9210

771 Pilot House Dr
#A
Newport News, VA 23606
Phone (757) 873-2302

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1503360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759968000000",
    "number": "1992221816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 412313",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022412313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10128 W BROAD ST BLDG III",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230606761",
            "telephone_number": "804-217-9210",
            "fax_number": "804-217-9213"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "210 Beatty Dr Ste 220",
            "address_purpose": "LOCATION",
            "city": "Belmont",
            "state": "NC",
            "postal_code": "280122716",
            "country_code": "US",
            "telephone_number": "704-500-0876",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DRAPER",
        "first_name": "TERI",
        "middle_name": "L.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-22",
        "last_updated": "2025-10-09",
        "certification_date": "2025-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P24209",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305211304",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "C05954",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Allen, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.