Individual provider Active NPI

Bryonna Woofter, DPT

  • Physical Therapist
  • Midlothian, VA
National Provider Identifier
1184394207
Registry record updated Feb 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305217576 Issued in VA
Practice address
2925 Polo Pkwy
Midlothian, VA 23113-1453
Phone
(804) 794-7587
Fax
(804) 794-4560
NPI assigned
Sep 20, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2305217576 VA Primary

Addresses

Primary practice location

2925 Polo Pkwy
Midlothian, VA 23113-1453

Mailing address

2122 York Rd Ste 300
Oak Brook, IL 60523-1925
Phone (630) 575-6200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260317002299 VA Practitioner - Physical Therapist in Private Practice 9234612326 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tidewater Physical Therapy LLCGroup PAC ID 6406759281, 225 clinicians

Practice addresses (Care Compare)

2925 Polo Pkwy
Midlothian, VA 23113-1453
Phone (804) 794-7587

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2305217576VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Tidewater Physical Therapy, LLC Physical Therapist CurrentSince Feb 5, 2026 Accepting new patients
Tidewater Physical Therapy, LLC Physical Therapist CurrentSince Feb 5, 2026 Accepting new patients
Athletico, LTD Physical Therapist CurrentSince Feb 5, 2026 Accepting new patients
Athletico LTD Physical Therapist CurrentSince Feb 5, 2026 Accepting new patients
Professional Sportscare & Rehab, LLC Physical Therapist CurrentSince Feb 5, 2026 Accepting new patients

Locations

2122 York Rd
Ste 300
Oak Brook, IL 60523
Phone (630) 575-6250

2925 Polo Pkwy
Midlothian, VA 23113
Phone (804) 323-9060

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1632096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770681600000",
    "number": "1184394207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 YORK RD STE 300",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231925",
            "telephone_number": "630-575-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2925 POLO PKWY",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231131453",
            "telephone_number": "804-794-7587",
            "fax_number": "804-794-4560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOFTER",
        "first_name": "BRYONNA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-20",
        "last_updated": "2026-02-10",
        "certification_date": "2026-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305217576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midlothian, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.