Provider Demographics
NPI:1871793901
Name:TOMPKINS ORTHOPEDIC PHYSICAL THERAPY SERVICES, PLC
Entity type:Organization
Organization Name:TOMPKINS ORTHOPEDIC PHYSICAL THERAPY SERVICES, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:TOMPKINS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:703-669-6100
Mailing Address - Street 1:22 FAIRFAX ST SE
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20175
Mailing Address - Country:US
Mailing Address - Phone:703-669-6100
Mailing Address - Fax:
Practice Address - Street 1:22 FAIRFAX ST SE
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20175
Practice Address - Country:US
Practice Address - Phone:703-669-6100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-18
Last Update Date:2018-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA23050022412251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA6400386OtherUNITED HEALTH CARE
VA192920OtherANTHEM
VA000008T63Medicare PIN
VA650000480Medicare PIN