Basic Information
| Provider Information | |||||||||
| NPI: | 1003806530 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TORODE | ||||||||
| FirstName: | SHERRI | ||||||||
| MiddleName: | D | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | P.T. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | TORODE | ||||||||
| OtherFirstName: | SHERRI | ||||||||
| OtherMiddleName: | D | ||||||||
| OtherNamePrefix: | MRS. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | P.T. | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | PO BOX 720 | ||||||||
| Address2: | |||||||||
| City: | AMHERST | ||||||||
| State: | VA | ||||||||
| PostalCode: | 245210720 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4349461314 | ||||||||
| FaxNumber: | 4349461083 | ||||||||
| Practice Location | |||||||||
| Address1: | 210 S MAIN ST | ||||||||
| Address2: | |||||||||
| City: | AMHERST | ||||||||
| State: | VA | ||||||||
| PostalCode: | 245212616 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4349461314 | ||||||||
| FaxNumber: | 4349461083 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/26/2005 | ||||||||
| LastUpdateDate: | 07/11/2010 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | Y | ||||||||
| IsOrganizationSubpart: | |||||||||
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| AuthorizedOfficialNamePrefix: | |||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 2305001459 | VA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
ID Information
| ID | Type | State | Issuer | Description | 210448 | 01 | VA | SOUTHERN HEALTH | OTHER | 542022159 | 01 | VA | TRICARE | OTHER | 010081211 | 05 | VA | MEDICAID | 650021581 | 01 | VA | RR MEDICARE | OTHER | 217635 | 01 | VA | BLUE CROSS BLUE SHIELD | OTHER |