Individual provider Active NPI

Brooke Nicole Trunnelle, PT, DPT

  • Physical Therapist
  • Williamsburg, VA
National Provider Identifier
1609609486
Registry record updated Oct 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305216748 Issued in VA
Practice address
201 Bulifants Blvd Ste B
Williamsburg, VA 23188-5731
Phone
(757) 792-1660
NPI assigned
Aug 26, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X
Physical Therapist 225100000X 2305216748 VA Primary

Addresses

Primary practice location

201 Bulifants Blvd Ste B
Williamsburg, VA 23188-5731

Mailing address

8379 Whirlaway St
Rancho Cucamonga, CA 91701-1322
Phone (909) 921-5906

Other practice location 1

5388 Discovery Park Blvd Ste 100
Williamsburg, VA 23188-8218
Phone (757) 346-1775

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
2305216748VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fusion Chiropractic, LLC CurrentSince Apr 24, 2022 Accepting new patients
Comber Physical Therapy, LLC Physical Therapist CurrentSince Sep 9, 2024 Accepting new patients

Locations

5388 Discovery Park Blvd
#2
Williamsburg, VA 23188

201 Bulifants Blvd
Ste B
Williamsburg, VA 23188
Phone (757) 229-9740

5388 Discovery Park Blvd
Ste 200
Williamsburg, VA 23188

5388 Discovery Park Blvd
Ste 100
Williamsburg, VA 23188
Phone (757) 707-3955

Organizations & group practices 2

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": "1724630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1609609486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8379 WHIRLAWAY ST",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917011322",
            "telephone_number": "909-921-5906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 BULIFANTS BLVD STE B",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231885731",
            "telephone_number": "757-792-1660"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5388 Discovery Park Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Williamsburg",
            "state": "VA",
            "postal_code": "231888218",
            "country_code": "US",
            "telephone_number": "757-346-1775",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRUNNELLE",
        "first_name": "BROOKE",
        "middle_name": "NICOLE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-26",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305216748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 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.