Proactive Therapy of Virginia, Inc.

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

PROACTIVE THERAPY OF VIRGINIA, INC.

Practice address

2426 Lee Hwy
Suite 102
Bristol, VA 24202-5967

Phone

(276) 645-0311

Fax

(276) 645-0302

NPI assigned

Jul 26, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Michael E. Tarvin

Title

Vice President

Phone

(717) 972-1139

Specialties & licenses 1

Addresses

Other names 1

• NovaCare Outpatient Rehabilitation Doing business as

Tax ID family

Novacare Outpatient Rehabilitation2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Select Cal Physical Therapy PC

  • Physical Therapy Clinic/Center
  • Laguna Niguel, CA
  • NPI 1457013047
  NPD tax ID

Locations

Practitioners 1

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

• Brady Lynn Carter, PT DPT

  • Physical Therapist
  • Bristol, VA
  • NPI 1487741054
  NPD (past)

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

{
    "created_epoch": "1122336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1992705545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4716 OLD GETTYSBURG RD",
            "address_2": "LEGAL DEPARTMEN",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170554325",
            "telephone_number": "717-972-1139",
            "fax_number": "717-975-9981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2426 LEE HWY",
            "address_2": "SUITE 102",
            "city": "BRISTOL",
            "state": "VA",
            "postal_code": "242025967",
            "telephone_number": "276-645-0311",
            "fax_number": "276-645-0302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROACTIVE THERAPY OF VIRGINIA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TARVIN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "717-972-1139",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NovaCare Outpatient Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tyler Lane Pittman, DDS
• Stephanie Lynn Poe, LCSW
• Carissa Poston, PHARM D
• Christine Powers, M. S.
• Marilyn M Powers, M.S., LPC
• Professional Pharmaceutical Services, Inc.
• Professional Therapies of Roanoke, Inc.
• Laken Bryanne Puckett, M.S. ATC
• Deborah Leachman Quesenberry, RDN, LDN
• Gracelyn K Ralston, STUDENT NURSE TECH

• Physical Therapy Clinic/Center in Bristol, VA
• Providers in Bristol, VA by specialty
• Physical Therapy Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.