1467515973 NPI number — NEW RIVER PHYSICAL THERAPY

Table of content: ROBERT DAVID THOMPSON MPT (NPI 1447409552)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467515973 NPI number — NEW RIVER PHYSICAL THERAPY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEW RIVER PHYSICAL THERAPY
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1467515973
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 3424
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RADFORD
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
24143-3424
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
540-639-9518
Provider Business Mailing Address Fax Number:
540-639-9521

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
27 CRESTVIEW DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RADFORD
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24143-3424
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-639-9518
Provider Business Practice Location Address Fax Number:
540-639-9521
Provider Enumeration Date:
12/18/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ARGABRITE
Authorized Official First Name:
JOSEPH
Authorized Official Middle Name:
WILLIAM
Authorized Official Title or Position:
DIRECTOR OF PHYSICAL THERAPY
Authorized Official Telephone Number:
540-639-9518

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  000332 , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225100000X , with the licence number: 0105000913 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 194304 . This is a "ANTHEM BCBS" identifier . This identifiers is of the category "OTHER".




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