Individual provider Active NPI

Brianna Lawless

  • Physical Therapist
  • Bloomfield, CT
National Provider Identifier
1124571989
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
14.011031 Issued in CT
Practice address
35 Jolley Dr
Bloomfield, CT 06002-3062
Phone
(860) 242-1578
Fax
(860) 242-1585
NPI assigned
Jul 28, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 14.011031 CT
Physical Therapist 225100000X 14.011031 CT Primary

Addresses

Primary practice location

35 Jolley Dr
Bloomfield, CT 06002-3062

Mailing address

10 Standish Rd
Ellington, CT 06029-3636

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200825000312 MA Practitioner - Physical Therapist in Private Practice 6204253172 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14.011031CTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
DG Physical Therapy, P.C. CurrentSince Apr 14, 2020 Accepting new patients
DG Physical Therapy PC CurrentSince Apr 14, 2020 Accepting new patients
DG Physical Therapy PC Physical Therapist Current Accepting new patients

Locations

4 Meeting House Rd
Ste 5
Chelmsford, MA 01824
Phone (978) 970-2460

185 West Ave
Ludlow, MA 01056
Phone (413) 583-2274

Organizations & group practices 3

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": "1469664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1124571989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 STANDISH RD",
            "city": "ELLINGTON",
            "state": "CT",
            "postal_code": "060293636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 JOLLEY DR",
            "city": "BLOOMFIELD",
            "state": "CT",
            "postal_code": "060023062",
            "telephone_number": "860-242-1578",
            "fax_number": "860-242-1585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWLESS",
        "first_name": "BRIANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-28",
        "last_updated": "2023-03-07",
        "certification_date": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CT",
            "license": "14.011031",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "14.011031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomfield, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.