Individual provider Active NPI

Brianna Kay Bennett

  • Physical Therapist
  • Raleigh, NC
National Provider Identifier
1023996451
Registry record updated Aug 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P24179 Issued in NC
Practice address
4109 Wake Forest Rd Ste 200
Raleigh, NC 27609-6262
Phone
(919) 322-0042
NPI assigned
Aug 25, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2025

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 P24179 NC Primary

Addresses

Primary practice location

4109 Wake Forest Rd Ste 200
Raleigh, NC 27609-6262

Mailing address

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

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251029000954 NC Practitioner - Physical Therapist in Private Practice 7315436565 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Activcare Physical Therapy, LLCGroup PAC ID 8628027471, 126 clinicians

Practice addresses (Care Compare)

4109 Wake Forest Rd
Suite 200
Raleigh, NC 27609-6262
Phone (919) 322-0042

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P24179NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Activcare Physical Therapy, LLC Physical Therapist CurrentSince Aug 25, 2025 Accepting new patients

Locations

2122 York Rd
Ste 300
Oak Brook, IL 60523
Phone (630) 575-6250

166 Springbrook Ave
Ste 201
Clayton, NC 27520
Phone (919) 535-8461

3410 Executive Dr
Ste 205
Raleigh, NC 27609
Phone (919) 322-0042

4109 Wake Forest Rd
Ste 200
Raleigh, NC 27609
Phone (919) 322-0042

Interoperability endpoints

  • Direct secure messaging: brianna.bennett.p12@direct.athleticoltd.nextgenshare.com

Organizations & group practices 1

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": "1756080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756080000000",
    "number": "1023996451",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4109 WAKE FOREST RD STE 200",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276096262",
            "telephone_number": "919-322-0042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "BRIANNA",
        "middle_name": "KAY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-25",
        "last_updated": "2025-08-25",
        "certification_date": "2025-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P24179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2025; 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.