Individual provider Active NPI

Jessica Lynn Brunner, PT, DPT

  • Physical Therapist
  • New Milford, NJ
National Provider Identifier
1275893232
Registry record updated May 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01401600 Issued in NJ
Practice address
332 Webster Dr
New Milford, NJ 07646-1118
Phone
(551) 265-4996
NPI assigned
May 24, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 40QA01401600 NJ Primary

Addresses

Primary practice location

332 Webster Dr
New Milford, NJ 07646-1118

Mailing address

332 Webster Dr
New Milford, NJ 07646-1118
Phone (551) 265-4996

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
40QA01401600NJMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1337817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337817600000",
    "number": "1275893232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "332 WEBSTER DR",
            "city": "NEW MILFORD",
            "state": "NJ",
            "postal_code": "076461118",
            "telephone_number": "551-265-4996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "332 WEBSTER DR",
            "city": "NEW MILFORD",
            "state": "NJ",
            "postal_code": "076461118",
            "telephone_number": "551-265-4996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNNER",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-24",
        "last_updated": "2012-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01401600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Milford, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2012; 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.