Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Leslie Prom, DPT

Individual provider Physical Therapist · NPI 1821461682

Leslie Prom, DPT is a Physical Therapist in Private Practice in Norfolk, Virginia. Qualified in 2004, 22 years ago. Practices with Old Dominion University, a 13-clinician group and accepts Medicare assignment. Licensed in Virginia.

Years since qualifying
22
Licensed in
VA
In the registry since
2015
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

1015 W 47th St
Norfolk, VA 23529-0001
Phone: (757) 683-7041
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 2305204676 (VA)

Record details

NPI number1821461682
Entity typeIndividual (Type 1)
GenderFemale
Credentials DPT
Sole proprietorNo
NPI enumeratedNovember 2, 2015
Last updated in NPPESNovember 2, 2015
Mailing address1015 W 47th St, Norfolk, VA 23529-0001

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Group practice Old Dominion University — 13 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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