Individual provider Active NPI

Brittany Burgess Wynn, DPT

  • Physical Therapist
  • Richmond, VA
National Provider Identifier
1528205192
Registry record updated Oct 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305205778 Issued in VA
Practice address
2924 Brook Rd
Children's Hospital
Richmond, VA 23220-1215
Phone
(804) 321-7474
Fax
(804) 228-5210
NPI assigned
Jan 19, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 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 2305205778 VA Primary

Addresses

Primary practice location

2924 Brook Rd
Children's Hospital
Richmond, VA 23220-1215

Mailing address

15733 Whirland Dr
Midlothian, VA 23112-5255
Phone (315) 573-2015

Other practice location 1

4840 Waller Rd
Richmond, VA 23230-2912
Phone (804) 893-5010

Other identifiers 1

IdentifierTypeStateIssuer
004909976MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2305205778VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Spot on Therapy Group LLC Physical Therapist Past Accepting new patients

Organizations & group practices 1

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": "1232323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1528205192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15733 WHIRLAND DR",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231125255",
            "telephone_number": "315-573-2015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2924 BROOK RD",
            "address_2": "CHILDREN'S HOSPITAL",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232201215",
            "telephone_number": "804-321-7474",
            "fax_number": "804-228-5210"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4840 Waller Rd",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232302912",
            "country_code": "US",
            "telephone_number": "804-893-5010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WYNN",
        "first_name": "BRITTANY",
        "middle_name": "BURGESS",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-19",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305205778",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004909976",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.