Brianna Lee Fairley, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT014299 Issued in GA

Practice address

1669 Phoenix Pkwy Ste 102
College Park, GA 30349-5462

Phone

(770) 907-1023

NPI assigned

Sep 6, 2019

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

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bfairley@selectmedical.com

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.

• Physiotherapy Associates Inc

  • Physical Therapy Clinic/Center
  • Lilburn, GA
  • NPI 1760568257
  Medicare reassignment NPD
• Physiotherapy Associates Inc

  • Physical Therapy Clinic/Center
  • Estero, FL
  • NPI 1720039902
  NPD

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

{
    "created_epoch": "1567728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567728000000",
    "number": "1114576733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5115 STONE CROFT TRL SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303317692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1669 PHOENIX PKWY STE 102",
            "city": "COLLEGE PARK",
            "state": "GA",
            "postal_code": "303495462",
            "telephone_number": "770-907-1023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIRLEY",
        "first_name": "BRIANNA",
        "middle_name": "LEE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-06",
        "last_updated": "2019-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT014299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "BFairley@selectmedical.com",
            "affiliation": "N",
            "address_1": "1669 Phoenix Pkwy Ste 102",
            "city": "College Park",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303495462",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "BFairley@selectmedical.com",
            "affiliation": "N",
            "address_1": "1669 Phoenix Pkwy Ste 102",
            "city": "College Park",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303495462",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Faith Pharmacy Inc
• Miranda L. Fallen-Bobo, LPC, NCC
• Family and Child Interventions
• Family Medical Center (Holding) P.C.
• Family Medical Center P.C.

• Physical Therapist in College Park, GA
• Providers in College Park, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2019; 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.