Larry D Briand, MS, PT, ATC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

4072024 Issued in WI

Practice address

2717 18TH St
Suite 100
Kenosha, WI 53140-4666

Phone

(262) 551-5650

Fax

(866) 245-8064

NPI assigned

Jun 8, 2006

Last updated

Dec 4, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417651200000",
    "number": "1275573198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3497",
            "city": "STURTEVANT",
            "state": "WI",
            "postal_code": "531773497",
            "telephone_number": "888-201-1040",
            "fax_number": "866-245-8064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2717 18TH ST",
            "address_2": "SUITE 100",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531404666",
            "telephone_number": "262-551-5650",
            "fax_number": "866-245-8064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIAND",
        "first_name": "LARRY",
        "middle_name": "D",
        "credential": "MS, PT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2014-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "4072024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "87951",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40189400",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "00186666001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2014; 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.