Form and Function Physical Therapy PLLC
NPI 1578265476 · Physical Therapy Clinic/Center · Glen Allen, VA
Enrolled with Medicare as Part B Supplier - Physical/Occupational Therapy Group in Private Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Form and Function Physical Therapy PLLC is a Physical Therapy Clinic/Center organization in Glen Allen, VA (NPI 1578265476).
Provider details
- NPI number
- 1578265476
- Entity type
- Organization
- Primary specialty
- Physical Therapy Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Pratik Shah, Ceo(804) 564-5194
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2023-03-22
- Last updated
- 2023-03-28
- Certified
- 2023-03-28
Frequently asked questions
- What is Form and Function Physical Therapy PLLC's NPI number?
- Form and Function Physical Therapy PLLC's National Provider Identifier (NPI) is 1578265476, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Form and Function Physical Therapy PLLC?
- Form and Function Physical Therapy PLLC is classified in the NPPES registry as Physical Therapy Clinic/Center (Ambulatory Health Care Facilities).
- Where is Form and Function Physical Therapy PLLC located?
- Form and Function Physical Therapy PLLC's practice location on file with NPPES is 11411 Hunton Cottage Ct, Glen Allen, VA 23059-4848.
- What is Form and Function Physical Therapy PLLC's phone number?
- The practice phone number listed in the NPPES registry for Form and Function Physical Therapy PLLC is (804) 564-5194.
- Does Form and Function Physical Therapy PLLC accept Medicare?
- Form and Function Physical Therapy PLLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Form and Function Physical Therapy PLLC?
- The authorized official listed on Form and Function Physical Therapy PLLC's NPPES record is Pratik Shah, Ceo. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Form and Function Physical Therapy PLLC's NPI active?
- Yes — Form and Function Physical Therapy PLLC's NPI (1578265476) is active in the NPPES registry as of the last update on 2023-03-28.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.