NPIMap

Individual provider Active NPI

Lindsey Ryan Brake, LRT/CTRS

  • Specialist
  • Greensboro, NC
National Provider Identifier
1265868129
Registry record updated Sep 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
2101 Issued in NC
Practice address
3607 Mhra 1111 Spring Garden St
Beyond Academics, the University of N.C. at Greensboro
Greensboro, NC 27412-5013
Phone
(336) 334-3855
Fax
(336) 334-3361
NPI assigned
Sep 23, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 2101 NC Primary

Addresses

Primary practice location

3607 Mhra 1111 Spring Garden St
Beyond Academics, the University of N.C. at Greensboro
Greensboro, NC 27412-5013

Mailing address

3607 Mhra 1111 Spring Garden St
Beyond Academics, the University of N.C. at Greensboro
Greensboro, NC 27412-5013
Phone (336) 334-3855

Other identifiers 1

IdentifierTypeStateIssuer
3418760MedicaidNC

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
2101NCMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1379894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379894400000",
    "number": "1265868129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3607 MHRA 1111 SPRING GARDEN ST",
            "address_2": "BEYOND ACADEMICS, THE UNIVERSITY OF N.C. AT GREENSBORO",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274125013",
            "telephone_number": "336-334-3855",
            "fax_number": "336-334-3361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3607 MHRA 1111 SPRING GARDEN ST",
            "address_2": "BEYOND ACADEMICS, THE UNIVERSITY OF N.C. AT GREENSBORO",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274125013",
            "telephone_number": "336-334-3855",
            "fax_number": "336-334-3361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAKE",
        "first_name": "LINDSEY",
        "middle_name": "RYAN",
        "name_prefix": "Ms.",
        "credential": "LRT/CTRS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-23",
        "last_updated": "2013-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NC",
            "license": "2101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3418760",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2013; 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.