Active NPI
Brittany Bianca Back, DPT
- Physical Therapist
- Lexington, KY
National Provider Identifier
1164077731
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 007704
- Practice address
- 2531 Old Rosebud Rd
Lexington, KY 40509-4574 - Phone
- (859) 554-1619
- NPI assigned
- Aug 9, 2019
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 007704 | KY | Primary |
Addresses
Primary practice location
2531 Old Rosebud Rd
Lexington, KY 40509-4574
Mailing address
2689 Braden Way Apt 44-2689
Lexington, KY 40509-8571
Phone (606) 276-7685
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| KYHAN5746431 | Other | KY | ANTHEM BLUECROSS BLUESHIELD |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 007704 | KY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1565308800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565308800000",
"number": "1164077731",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2689 BRADEN WAY APT 44-2689",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405098571",
"telephone_number": "606-276-7685"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2531 OLD ROSEBUD RD",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405094574",
"telephone_number": "859-554-1619"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BACK",
"first_name": "BRITTANY",
"middle_name": "BIANCA",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-08-09",
"last_updated": "2019-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "KY",
"license": "007704",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BLUECROSS BLUESHIELD",
"identifier": "KYHAN5746431",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lexington, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.