Individual provider Active NPI

Jennifer R Wornom, PT, OCS

  • Physical Therapist
  • Hampton, VA
National Provider Identifier
1639228356
Registry record updated Feb 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305005217 Issued in VA
Practice address
901 Enterprise Pkwy Ste 900
Hampton, VA 23666-6250
Phone
(757) 827-2480
Fax
(757) 827-2566
NPI assigned
Jan 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 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 2305005217 VA Primary

Addresses

Primary practice location

901 Enterprise Pkwy Ste 900
Hampton, VA 23666-6250

Mailing address

901 Enterprise Pkwy Ste 900
Hampton, VA 23666-6250
Phone (757) 827-2480

Other identifiers 3

IdentifierTypeStateIssuer
192931OtherVABCBS (PHYS. THERAPY)
3001754142MedicaidVA
5046653OtherVAAETNA

Other names 1

  • Miss Jennifer Rhoad Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090925000400 VA Practitioner - Physical Therapist in Private Practice 7113073545 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

901 Enterprise Pkwy
Suite 900
Hampton, VA 23666-6250
Phone (757) 827-2480

Merit-based Incentive Payment System (MIPS)

Final score
94.1 of 100Reported as group
Quality
91.92
Promoting interoperability
97
Improvement activities
40
Cost
90.92

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Tidewater Physical Therapy, LLC Physical Therapist CurrentSince Aug 5, 2009 Accepting new patients
Tidewater Physical Therapy, LLC Physical Therapist CurrentSince Aug 5, 2009 Accepting new patients
Tidewater Physical Therapy, LLC Physical Therapist Current Accepting new patients
Tidewater Orthopaedic Associates Inc Physical Therapist CurrentSince Nov 6, 2010 Accepting new patients
Tidewater Orthopaedic Associates Inc CurrentSince Nov 6, 2010 Accepting new patients
Tidewater Orthopaedic Associates Inc Physical Therapist Past Accepting new patients

Locations

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

901 Enterprise Pkwy
Ste 900
Hampton, VA 23666
Phone (757) 827-2480

771 Pilot House Dr
Newport News, VA 23606
Phone (757) 873-2302

4037 Ironbound Rd
Williamsburg, VA 23188
Phone (757) 206-1004

Organizations & group practices 6

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": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1639228356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 ENTERPRISE PKWY STE 900",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236666250",
            "telephone_number": "757-827-2480",
            "fax_number": "757-827-2566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 ENTERPRISE PKWY STE 900",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236666250",
            "telephone_number": "757-827-2480",
            "fax_number": "757-827-2566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORNOM",
        "first_name": "JENNIFER",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "PT, OCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-10",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305005217",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS (PHYS. THERAPY)",
            "identifier": "192931",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3001754142",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5046653",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "RHOAD",
            "prefix": "MISS",
            "credential": "PT, OCS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hampton, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 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.