Individual provider Active NPI

Niya Brackett, PT, DPT

  • Physical Therapist
  • Southlake, TX
National Provider Identifier
1184512337
Registry record updated Jun 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
910 E Southlake Blvd Ste 155
Southlake, TX 76092-6389
Phone
(817) 421-5000
NPI assigned
Jun 26, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

910 E Southlake Blvd Ste 155
Southlake, TX 76092-6389

Mailing address

400 W Main St Apt 4045
Lewisville, TX 75057-3786
Phone (205) 516-6151

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250717001989 TX Practitioner - Physical Therapist in Private Practice 7214442292 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Las Colinas Orthopedic Surgery and Sports Medicine P.a. CurrentSince Jun 2, 2025 Accepting new patients
Las Colinas Orthopedic Surgery & Sports Medicine P.a. CurrentSince Jun 2, 2025 Accepting new patients

Locations

910 E Southlake Blvd
Ste 155
Southlake, TX 76092
Phone (817) 421-5000

Interoperability endpoints

  • Direct secure messaging: niya.brackett.1@15749.direct.athenahealth.com

Organizations & group practices 2

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": "1750896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750896000000",
    "number": "1184512337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 W MAIN ST APT 4045",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750573786",
            "telephone_number": "205-516-6151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 E SOUTHLAKE BLVD STE 155",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926389",
            "telephone_number": "817-421-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRACKETT",
        "first_name": "NIYA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-26",
        "last_updated": "2025-06-26",
        "certification_date": "2025-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southlake, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2025; 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.