MEDICARE: HUMMINGBIRD THERAPY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1255221248
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HUMMINGBIRD THERAPY LLC

Provider Business Mailing Address
First Line	:	4633 PEMBROKE LAKE CIR STE 100
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23455-6404
Country	:	US
Telephone Number	:	757-689-7446
Fax Number	:	888-495-6165

Provider Business Practice Location Address
First Line	:	4633 PEMBROKE LAKE CIR STE 100
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23455-6404
Country	:	US
Telephone Number	:	757-689-7446
Fax Number	:	888-495-6165

Authorized Official
Title or Position	:	PHYSICAL THERAPIST/OWNER
Name	:	KATIE MEYER
Credential	:	PT
Telephone Number	:	757-689-7446

Provider Enumeration Date	:	07/09/2025
Last Update Date	:	07/09/2025

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