Breanna Blackburn

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA0014115 Issued in CO

Practice address

416 W Blair Ave
Rock Springs, WY 82901-7113

Phone

(307) 382-3242

NPI assigned

May 11, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Seppie Physical Therapy, LLC

  • Physical Therapist
  • Rock Springs, WY
  • NPI 1578968152
  NPD (past)

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494460800000",
    "number": "1023544822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 W BLAIR AVE",
            "city": "ROCK SPRINGS",
            "state": "WY",
            "postal_code": "829017113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 W BLAIR AVE",
            "city": "ROCK SPRINGS",
            "state": "WY",
            "postal_code": "829017113",
            "telephone_number": "307-382-3242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKBURN",
        "first_name": "BREANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-11",
        "last_updated": "2017-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CO",
            "license": "PTA0014115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Richard Bibber
• Jaden Rochelle Bingham, APRN, FNP-BC
• Joshua Thomas Binks, M.D.
• Bitter Creek Inpatient Services LLC
• Ragnvaldr Buck Bjornsson, MD
• Susan Jean Blevins, M.A
• Katherine Bodman
• Troy Daniel Boerner
• Edmund C Boese, MD
• Alyssa Bond

• Physical Therapy Assistant in Rock Springs, WY
• Providers in Rock Springs, WY by specialty
• Physical Therapy Assistant in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2017; 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.