Individual provider Active NPI

Liane Brown, PT, DPT

  • Physical Therapist
  • North Syracuse, NY
National Provider Identifier
1003215450
Registry record updated Sep 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
62038072 Issued in NY
Practice address
792 N Main St
Ste 100C
North Syracuse, NY 13212-1644
Phone
(315) 458-2552
Fax
(315) 458-2575
NPI assigned
Aug 21, 2014
Last updated
Sep 30, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2016

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 62038072 NY Primary

Addresses

Primary practice location

792 N Main St
Ste 100C
North Syracuse, NY 13212-1644

Mailing address

792 N Main St
Ste 100C
North Syracuse, NY 13212-1644
Phone (315) 458-2552

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141027001728 NY Practitioner - Physical Therapist in Private Practice 9032330535 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038072NYMDPeriodontist
62038072NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Liverpool Physical Therapy, PC Physical Therapist CurrentSince Aug 12, 2014 Accepting new patients
Oswego Hospital CurrentSince Oct 1, 2017 Accepting new patients

Locations

718 Old Liverpool Rd
Liverpool, NY 13088
Phone (315) 457-7005

110 W 6th St
Oswego, NY 13126
Phone (315) 349-5511

1001 W Fayette St
Ste 400
Syracuse, NY 13204
Phone (315) 472-1488

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1408579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475193600000",
    "number": "1003215450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "792 N MAIN ST",
            "address_2": "STE 100C",
            "city": "NORTH SYRACUSE",
            "state": "NY",
            "postal_code": "132121644",
            "telephone_number": "315-458-2552",
            "fax_number": "315-458-2575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "792 N MAIN ST",
            "address_2": "STE 100C",
            "city": "NORTH SYRACUSE",
            "state": "NY",
            "postal_code": "132121644",
            "telephone_number": "315-458-2552",
            "fax_number": "315-458-2575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "LIANE",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-21",
        "last_updated": "2016-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "62038072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.