Elizabeth Renee Bryan, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT-5826 Issued in ID

Practice address

130 S Midland Blvd
Nampa, ID 83686

Phone

(208) 461-5057

Fax

(208) 461-5210

NPI assigned

Jan 12, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Altitude Physical Therapy, Inc.

  • Physical Therapy Clinic/Center
  • Caldwell, ID
  • NPI 1619045309
  Medicare reassignment NPD

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

{
    "created_epoch": "1326326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531872000000",
    "number": "1104196724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 S. 13TH STREET",
            "address_2": "P.O. BOX 9996",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 S MIDLAND BLVD",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "83686",
            "telephone_number": "208-461-5057",
            "fax_number": "208-461-5210"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7033 Commonwealth Ave",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322202851",
            "country_code": "US",
            "telephone_number": "904-378-3202",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRYAN",
        "first_name": "ELIZABETH",
        "middle_name": "RENEE",
        "name_prefix": "Ms.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-12",
        "last_updated": "2018-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "27080",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-5826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brownfields Inc
• Renelle Lashae Brubaker, LPC
• Rona M Brumpton, LCPC, LMFT
• Justin Bruner, D.O.
• Mario Brus, MD
• Rodney Ray Bryant, RPH
• Stephen C Bryant, DMD
• Brandy Buchanan
• Camille Buchmiller Buchmiller, PA
• Jeffrey Buckingham

• Physical Therapist in Nampa, ID
• Providers in Nampa, ID by specialty
• Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2018; 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.