Active NPI
Brianna Mandry
- Physical Therapist
- Arvada, CO
National Provider Identifier
1104435965
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PTL0017584
- Practice address
- 7878 Wadsworth Blvd BLDG Suite210
Arvada, CO 80003-2146 - Phone
- (303) 456-8967
- NPI assigned
- Jul 28, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | P19782 | NC | |
| Physical Therapist | 225100000X | PTL0017584 | CO | Primary |
Addresses
Primary practice location
7878 Wadsworth Blvd BLDG Suite210
Arvada, CO 80003-2146
Mailing address
7878 Wadsworth Blvd BLDG Suite210
Arvada, CO 80003-2146
Phone (303) 456-8967
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
| License | State | Type | Specialty |
|---|---|---|---|
| PTL0017584 | CO | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1595894400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642636800000",
"number": "1104435965",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7878 WADSWORTH BLVD BLDG SUITE210",
"city": "ARVADA",
"state": "CO",
"postal_code": "800032146",
"telephone_number": "303-456-8967"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7878 WADSWORTH BLVD BLDG SUITE210",
"city": "ARVADA",
"state": "CO",
"postal_code": "800032146",
"telephone_number": "303-456-8967"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANDRY",
"first_name": "BRIANNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-07-28",
"last_updated": "2022-01-20",
"certification_date": "2022-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "NC",
"license": "P19782",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CO",
"license": "PTL0017584",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Arvada, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.