Provider Demographics
NPI:1144537259
Name:BROWN, REINA M (PT, DPT)
Entity type:Individual
Prefix:
First Name:REINA
Middle Name:M
Last Name:BROWN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:REINA
Other - Middle Name:M
Other - Last Name:CHAPERON SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:PO BOX 69030
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-9030
Mailing Address - Country:US
Mailing Address - Phone:757-873-2302
Mailing Address - Fax:757-873-2306
Practice Address - Street 1:9 MANHATTAN SQ STE B
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-6263
Practice Address - Country:US
Practice Address - Phone:757-825-3400
Practice Address - Fax:757-825-0392
Is Sole Proprietor?:No
Enumeration Date:2010-09-10
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305207423225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1144537259Medicaid
VAP01450974OtherMEDICARE RR PTAN
VAC05954OtherMEDICARE GROUP PTAN
VAP01450974OtherMEDICARE RR PTAN