Individual provider Active NPI

Brianna Vallandingham, PTA

  • Physical Therapy Assistant
  • Orlando, FL
National Provider Identifier
1215657077
Registry record updated Sep 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA32163 Issued in FL
Practice address
6000 Turkey Lake Rd Ste 114
Orlando, FL 32819-4205
Phone
(321) 732-3723
NPI assigned
Aug 31, 2022
Last updated
Sep 2, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Rehabilitation Medicine Physician 2081P0010X PTA32163 FL
Physical Therapy Assistant 225200000X PTA32163 FL Primary

Addresses

Primary practice location

6000 Turkey Lake Rd Ste 114
Orlando, FL 32819-4205

Mailing address

409 Saint Anns Dr
Winter Haven, FL 33884-3564
Phone (863) 944-1979

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

LicenseStateTypeSpecialty
PTA32163FLMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Little Tesla Pediatric Therapy LLC PastSince Sep 4, 2022 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1661904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662076800000",
    "number": "1215657077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 SAINT ANNS DR",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338843564",
            "telephone_number": "863-944-1979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 TURKEY LAKE RD STE 114",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328194205",
            "telephone_number": "321-732-3723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALLANDINGHAM",
        "first_name": "BRIANNA",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-31",
        "last_updated": "2022-09-02",
        "certification_date": "2022-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine",
            "state": "FL",
            "license": "PTA32163",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA32163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2022; 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.