Brittany Buckley, DPT
Individual provider Active NPI Physical Therapist · Wilton, CT
NPI 1265043053 · NPPES record last updated Aug 14, 2020
Key facts
- NPI
- 1265043053
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 12831 (CT)
- Practice address
- 396 Danbury Rd Unit 5
Wilton, CT 06897-2024 - Phone
- (203) 978-3343
- Fax
- (203) 529-3215
- NPI assigned
- Aug 14, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2020
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Dynamic Edge Physiotherapy LLC
Practice addresses (Care Compare)
396 Danbury Rd
Unit 5
Wilton, CT 06897-2024
Phone (203) 978-3343
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201014000671 | CT | Practitioner - Physical Therapist in Private Practice | 1658791611 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12831 | CT | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dynamic Edge Physiotherapy LLC | Physical Therapist | Current |
Accepting new patients |
| Dynamic Edge Physiotherapy Monroe LLC | Past |
Accepting new patients |
Locations
396 Danbury Rd
Unit 5
Wilton, CT 06897
Phone (203) 978-3313
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 12831 | CT | Yes |
Addresses
Primary practice location
396 Danbury Rd Unit 5
Wilton, CT 06897-2024
Mailing address
396 Danbury Rd Unit 5
Wilton, CT 06897-2024
Phone (203) 978-3343
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | bbuckley@dynamicedgept.com | Direct |
Other providers in Wilton, CT
- Elizabeth Eleanor Brown
- Lori Sue Brown
- Richard Brown
- Kenneth R. Bruno II
- Millie Suzanne Bryant-Giannini
- Lauren M. Buckley
- Patrick Kim Buckley
- Aaron O Buffardi
- Denise W Bulpitt
- Shannon Houpt Bunting
All providers in Wilton, CT · Physical Therapist in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 14, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.