Individual provider Active NPI

Brittany Gardner, PT

  • Occupational Therapist
  • Soldotna, AK
National Provider Identifier
1184918732
Registry record updated Jul 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
2325 Issued in AK
Practice address
35105 Kenai Spur Hwy
Soldotna, AK 99669-7621
Phone
(907) 260-7444
Fax
(907) 260-7400
NPI assigned
May 31, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2290 AK
Occupational Therapist 225X00000X 2325 AK Primary

Addresses

Primary practice location

35105 Kenai Spur Hwy
Soldotna, AK 99669-7621

Mailing address

35105 Kenai Spur Hwy
Soldotna, AK 99669-7621
Phone (907) 260-7444

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221212000433 AK Practitioner - Physical Therapist in Private Practice 2961676523 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alaska Aquatic Therapy, Inc.Group PAC ID 6800864604, 13 clinicians

Practice addresses (Care Compare)

35932 Kenai Spur Hwy
Soldotna, AK 99669-7103
Phone (907) 398-0411

46188 Sterling Hwy
Soldotna, AK 99669-9202
Phone (907) 398-0411

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2290AKMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Alaska Kids Talk, LLC Past Accepting new patients
Occupational Rehabilitative Services Inc Occupational Therapist Past Accepting new patients

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": "1306800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311811200000",
    "number": "1184918732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35105 KENAI SPUR HWY",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996697621",
            "telephone_number": "907-260-7444",
            "fax_number": "907-260-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35105 KENAI SPUR HWY",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996697621",
            "telephone_number": "907-260-7444",
            "fax_number": "907-260-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "BRITTANY",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-31",
        "last_updated": "2011-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AK",
            "license": "2290",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AK",
            "license": "2325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Soldotna, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.