Active NPI
Bryan Burdett Wright, PT
- Physical Therapist
- Fairfield, OH
National Provider Identifier
1295042323
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT09412
- Practice address
- 2960 Mack Rd
Suite 103
Fairfield, OH 45014-5373 - Phone
- (513) 870-5342
- Fax
- (513) 870-5343
- NPI assigned
- Sep 10, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT09412 | OH | Primary |
Addresses
Primary practice location
2960 Mack Rd
Suite 103
Fairfield, OH 45014-5373
Mailing address
534 Tara CT
Germantown, OH 45327-1638
Phone (937) 238-8643
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
| License | State | Type | Specialty |
|---|---|---|---|
| PT09412 | OH | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1284076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1284076800000",
"number": "1295042323",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "534 TARA CT",
"city": "GERMANTOWN",
"state": "OH",
"postal_code": "453271638",
"telephone_number": "937-238-8643",
"fax_number": "937-238-8864"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2960 MACK RD",
"address_2": "SUITE 103",
"city": "FAIRFIELD",
"state": "OH",
"postal_code": "450145373",
"telephone_number": "513-870-5342",
"fax_number": "513-870-5343"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WRIGHT",
"first_name": "BRYAN",
"middle_name": "BURDETT",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-09-10",
"last_updated": "2010-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OH",
"license": "PT09412",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfield, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.