Individual provider Active NPI

Brittany Roberts, DPT

  • Physical Therapist
  • Lake Placid, FL
National Provider Identifier
1265942122
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT42420 Issued in FL
Practice address
490 US 27 S
Lake Placid, FL 33852
Phone
(863) 465-9500
NPI assigned
Oct 5, 2017
Last updated
Jan 22, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

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 2017026998 MO
Physical Therapist 225100000X PT42420 FL Primary

Addresses

Primary practice location

490 US 27 S
Lake Placid, FL 33852

Mailing address

490 US 27 S
Lake Placid, FL 33852
Phone (863) 465-9500

Other practice location 1

1480 8th St
West Plains, MO 65775-2010
Phone (417) 256-5669

Other practice location 2

100 W US Highway 60
Mountain View, MO 65548-8542
Phone (417) 934-7050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201006002096 MO Practitioner - Physical Therapist in Private Practice 6002235371 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT42420FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Therapy Specialist Clinic, Inc. Physical Therapist CurrentSince Oct 12, 2020 Accepting new patients

Locations

1206 N Main St
Mountain Grv, MO 65711
Phone (417) 926-5699

1480 8th St
West Plains, MO 65775
Phone (417) 256-5669

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": "1507161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1265942122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "490 US 27 S",
            "city": "LAKE PLACID",
            "state": "FL",
            "postal_code": "33852",
            "telephone_number": "863-465-9500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "490 US 27 S",
            "city": "LAKE PLACID",
            "state": "FL",
            "postal_code": "33852",
            "telephone_number": "863-465-9500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1480 8th St",
            "address_purpose": "LOCATION",
            "city": "West Plains",
            "state": "MO",
            "postal_code": "657752010",
            "country_code": "US",
            "telephone_number": "417-256-5669",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 W US Highway 60",
            "address_purpose": "LOCATION",
            "city": "Mountain View",
            "state": "MO",
            "postal_code": "655488542",
            "country_code": "US",
            "telephone_number": "417-934-7050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "BRITTANY",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-05",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2017026998",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT42420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Placid, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.