Individual provider Active NPI

Jessica Fontana, DPT

  • Physical Therapist
  • Richmond, VA
National Provider Identifier
1629790530
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305216089 Issued in VA
Practice address
2040 John Rolfe Pkwy
Richmond, VA 23238-8111
Phone
(804) 754-0916
NPI assigned
Sep 16, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 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 302423 CA
Physical Therapist 225100000X 2305216089 VA Primary

Addresses

Primary practice location

2040 John Rolfe Pkwy
Richmond, VA 23238-8111

Mailing address

2122 York Rd Ste 300
Oak Brook, IL 60523-1925
Phone (570) 550-0168

Other practice location 1

7 Atlas St
Westerly, RI 02891-3115
Phone (401) 932-9921

Medicare participation

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

Care Compare profile

Medicare Care Compare

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
302423CAMDPhysical Therapist
2305216089VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Tidewater Physical Therapy, LLC Physical Therapist CurrentSince Oct 16, 2023 Accepting new patients
Tidewater Physical Therapy, LLC Physical Therapist CurrentSince Oct 16, 2023 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

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

12494 Warwick Blvd
Newport News, VA 23606
Phone (804) 217-9210

2040 John Rolfe Pkwy
Richmond, VA 23238
Phone (804) 754-0916

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": "1663286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1629790530",
    "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": "570-550-0168",
            "fax_number": "410-648-4878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 JOHN ROLFE PKWY",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232388111",
            "telephone_number": "804-754-0916"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7 Atlas St",
            "address_purpose": "LOCATION",
            "city": "Westerly",
            "state": "RI",
            "postal_code": "028913115",
            "country_code": "US",
            "telephone_number": "401-932-9921",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FONTANA",
        "first_name": "JESSICA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-16",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "302423",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305216089",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Aug 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.