Brad Richard Greenawalt, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT015546 Issued in PA

Practice address

1 Nolte Dr
Kittanning, PA 16201-7111

Phone

(724) 543-8880

Fax

(724) 543-8788

NPI assigned

Feb 15, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Anderson Physical Therapy Etc PC

  • Physical Therapist
  • Seneca, PA
  • NPI 1487647376
  NPD (past)

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174666317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 579",
            "city": "KITTANNING",
            "state": "PA",
            "postal_code": "162010579",
            "telephone_number": "724-543-8880",
            "fax_number": "724-543-8788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 NOLTE DR",
            "city": "KITTANNING",
            "state": "PA",
            "postal_code": "162017111",
            "telephone_number": "724-543-8880",
            "fax_number": "724-543-8788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENAWALT",
        "first_name": "BRAD",
        "middle_name": "RICHARD",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT015546",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA STATE LICENSE NUMBER",
            "identifier": "PT015546",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jillian Lisa Glover
• Colleen Gordon, LPC
• Kerri Lynn Grafton, PHARMD
• Isaac Greeley, D.C.
• Natalie Green
• Roderick Berl Groomes, MD
• Crista Jo Hammel
• Nathan Thomas Hand
• Lynda Suzanne Harasty
• Maryellen Harnish, RN

• Physical Therapist in Kittanning, PA
• Providers in Kittanning, PA by specialty
• Physical Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.