Individual provider Active NPI

Brooke B Pettyjohn, PT, DPT

  • Physical Therapist
  • Lynchburg, VA
National Provider Identifier
1811320161
Registry record updated Sep 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305208140 Issued in VA
Practice address
2405 Atherholt Rd
Lynchburg, VA 24501-2184
Phone
(434) 485-8500
Fax
(434) 485-8599
NPI assigned
Aug 9, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2020

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 2305208140 VA Primary

Addresses

Primary practice location

2405 Atherholt Rd
Lynchburg, VA 24501-2184

Mailing address

2405 Atherholt Rd
Lynchburg, VA 24501-2184
Phone (434) 485-8500

Other identifiers 1

IdentifierTypeStateIssuer
1811320161MedicaidVA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bpettyjohn6164@direct.orthovirginia.com Other

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131002000097 VA Practitioner - Physical Therapist in Private Practice 6709010945 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthovirginia IncGroup PAC ID 0547157224, 570 clinicians

Practice addresses (Care Compare)

2405 Atherholt Rd
Lynchburg, VA 24501-2184
Phone (434) 485-8517

Merit-based Incentive Payment System (MIPS)

Final score
90.85 of 100Reported as group
Quality
90.74
Promoting interoperability
100
Improvement activities
40
Cost
78.74

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Orthovirginia, Inc. Physical Therapist CurrentSince Jan 1, 2016 Accepting new patients
Orthovirginia, Inc CurrentSince Jan 1, 2016 Accepting new patients
Orthovirginia Inc Physical Therapist Current Accepting new patients
Orthovirginia, Inc. Past Accepting new patients

Locations

2405 Atherholt Rd
Lynchburg, VA 24501
Phone (434) 485-8500

8200 Meadowbridge Rd
Ste 200
Mechanicsville, VA 23116
Phone (804) 560-5595

1115 Boulders Pkwy
Ste 200
North Chesterfield, VA 23225
Phone (804) 327-9242

Interoperability endpoints

  • FHIR API: https://epicproxy.et1015.epichosted.com/FHIRProxy/api/FHIR/R4/
  • Direct secure messaging: bpettyjohn6164@direct.orthovirginia.com

Organizations & group practices 4

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": "1376006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600128000000",
    "number": "1811320161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2405 ATHERHOLT RD",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245012184",
            "telephone_number": "434-485-8500",
            "fax_number": "434-485-8599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2405 ATHERHOLT RD",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245012184",
            "telephone_number": "434-485-8500",
            "fax_number": "434-485-8599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTYJOHN",
        "first_name": "BROOKE",
        "middle_name": "B",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-09",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305208140",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1811320161",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bpettyjohn6164@direct.orthovirginia.com",
            "affiliation": "N",
            "endpointDescription": "Dr. Pettyjohn direct address",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "secure messaging",
            "address_1": "2405 Atherholt Rd",
            "city": "Lynchburg",
            "state": "VA",
            "country_code": "US",
            "postal_code": "245012184",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lynchburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2020; 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.