Individual provider Active NPI

Bryan W Hutton, PT DPT CSCS

  • Physical Therapist
  • Chester, VA
National Provider Identifier
1467925784
Registry record updated Dec 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305212566 Issued in VA
Practice address
10438 Iron Bridge Rd
Chester, VA 23831-1427
Phone
(804) 796-1518
Fax
(804) 796-1543
NPI assigned
Jan 9, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2024

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 2305212566 VA Primary

Addresses

Primary practice location

10438 Iron Bridge Rd
Chester, VA 23831-1427

Mailing address

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

Other practice location 1

17453 Jefferson Davis Hwy
Dumfries, VA 22026-2244
Phone (703) 221-3931

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190619000265 VA Practitioner - Physical Therapist in Private Practice 5799019121 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Marymount University, 2018
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)

300 B Temple Lake Dr
Suite 1
Colonial Heights, VA 23834-2973
Phone (804) 524-9036

Merit-based Incentive Payment System (MIPS)

Final score
88.16 of 100Reported as group
Quality
85.78
Promoting interoperability
99
Improvement activities
40
Cost
75.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2305212566VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Tidewater Physical Therapy, LLC Physical Therapist CurrentSince Aug 17, 2020 Accepting new patients
Tidewater Physical Therapy, LLC Physical Therapist CurrentSince Aug 17, 2020 Accepting new patients
Coach House Physicial Therapy&Sports Medicine Center, LLC Physical Therapist Past Accepting new patients

Locations

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

350 New Fidelity Ct
Garner, NC 27529
Phone (919) 373-2919

10438 Iron Bridge Rd
Chester, VA 23831
Phone (804) 248-8277

300B Temple Lake Dr
Ste 1
Colonial Heights, VA 23834
Phone (804) 452-4903

10128 W Broad St
Bldg Iii
Glen Allen, VA 23060
Phone (804) 217-9210

Organizations & group practices 3

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": "1546992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734048000000",
    "number": "1467925784",
    "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",
            "fax_number": "410-648-4878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10438 IRON BRIDGE RD",
            "city": "CHESTER",
            "state": "VA",
            "postal_code": "238311427",
            "telephone_number": "804-796-1518",
            "fax_number": "804-796-1543"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17453 Jefferson Davis Hwy",
            "address_purpose": "LOCATION",
            "city": "Dumfries",
            "state": "VA",
            "postal_code": "220262244",
            "country_code": "US",
            "telephone_number": "703-221-3931",
            "fax_number": "703-221-3932",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUTTON",
        "first_name": "BRYAN",
        "middle_name": "W",
        "credential": "PT DPT CSCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-09",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305212566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chester, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2024; 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.