Individual provider Active NPI

Brenda Larrivee, MSPT

  • Physical Therapist
  • Cranston, RI
National Provider Identifier
1245282805
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT01692 Issued in RI
Practice address
721 Reservoir Ave
Cranston, RI 02910-4430
Phone
(401) 946-4250
Fax
(401) 275-5645
NPI assigned
May 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT01692 RI Primary
Physical Therapist 225100000X PT9234 MA
Physical Therapist 225100000X PT11336 CA

Addresses

Primary practice location

721 Reservoir Ave
Cranston, RI 02910-4430

Mailing address

721 Reservoir Ave
Cranston, RI 02910-4430
Phone (401) 946-4250

Other identifiers 1

IdentifierTypeStateIssuer
410523OtherRIBLUECHIP RI IND. ID #

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
9234MAMDMental Health Counselor
PT11336CAMDPhysical Therapist
PT9234MAMDPhysical Therapist
PT01692RIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Back on Track, P.C. Physical Therapist Past Accepting new patients
Back on Track, P.C. Physical Therapist PastSince Apr 20, 2016 Accepting new patients

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": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1245282805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 RESERVOIR AVE",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029104430",
            "telephone_number": "401-946-4250",
            "fax_number": "401-275-5645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 RESERVOIR AVE",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029104430",
            "telephone_number": "401-946-4250",
            "fax_number": "401-275-5645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARRIVEE",
        "first_name": "BRENDA",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-16",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "RI",
            "license": "PT01692",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "PT9234",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT11336",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECHIP RI IND. ID #",
            "identifier": "410523",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cranston, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.