Individual provider Active NPI

Elizabeth A Brueggemann, MPT

  • Physical Therapist
  • Yakima, WA
National Provider Identifier
1073655809
Registry record updated Nov 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00009574 Issued in WA
Practice address
1211 N 16TH Ave
Yakima, WA 98902-1347
Phone
(509) 454-8888
Fax
(509) 453-0061
NPI assigned
Feb 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2013

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 PT00009574 WA Primary

Addresses

Primary practice location

1211 N 16TH Ave
Yakima, WA 98902-1347

Mailing address

1211 N 16TH Ave
Yakima, WA 98902-1347
Phone (509) 454-8888

Other names 1

  • Elizabeth Ann Dempster Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT00009574WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Creekside Physical Therapy, PLLC Physical Therapist PastSince Mar 23, 2018 Accepting new patients
Central Washington Physical Therapy Physical Therapist PastSince Oct 18, 1999 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384473600000",
    "number": "1073655809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 N 16TH AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989021347",
            "telephone_number": "509-454-8888",
            "fax_number": "509-453-0061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 N 16TH AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989021347",
            "telephone_number": "509-454-8888",
            "fax_number": "509-453-0061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUEGGEMANN",
        "first_name": "ELIZABETH",
        "middle_name": "A",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-12",
        "last_updated": "2013-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00009574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "DEMPSTER",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Yakima, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2013; 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.