Individual provider Active NPI

Brianne Christine Vannucci, PT, DPT

  • Physical Therapist
  • Gilbert, AZ
National Provider Identifier
1225547904
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
30615 Issued in AZ
Practice address
1551 E Elliot Rd
Gilbert, AZ 85234-7002
Phone
(602) 686-0886
NPI assigned
Sep 25, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

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 293769 CA
Physical Therapist 225100000X 30615 AZ Primary

Addresses

Primary practice location

1551 E Elliot Rd
Gilbert, AZ 85234-7002

Mailing address

2823 S Lynch
Mesa, AZ 85212-2185
Phone (602) 686-0886

Other practice location 1

2823 S Lynch
Mesa, AZ 85212-2185
Phone (602) 686-0886

Other names 1

  • Dr. Brianne Christine Hatherill Former name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
30615AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Endure Performance Training LLC CurrentSince Sep 10, 2023 Accepting new patients
BHSM Rehabilitation, LLC Past Accepting new patients
Avicenna Integrative Medicine PLC Past Accepting new patients
BHSM Rehabilitation, LLC Past Accepting new patients
Core Performance Physical Therapy, Inc. Physical Therapist PastSince Sep 1, 2011 Accepting new patients

Locations

1551 E Elliot Rd
Gilbert, AZ 85234
Phone (602) 686-0886

Organizations & group practices 5

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": "1506297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1225547904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2823 S LYNCH",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852122185",
            "telephone_number": "602-686-0886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 E ELLIOT RD",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852347002",
            "telephone_number": "602-686-0886"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2823 S Lynch",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852122185",
            "country_code": "US",
            "telephone_number": "602-686-0886",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANNUCCI",
        "first_name": "BRIANNE",
        "middle_name": "CHRISTINE",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-25",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "293769",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "30615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRIANNE",
            "last_name": "HATHERILL",
            "middle_name": "CHRISTINE",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; 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.