Bryan Paul Whitesides, MPT, OCS

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PTL.0006022 Issued in CO

Practice address

627 25 1/2 Rd
Grand Junction, CO 81505-6401

Phone

(970) 242-3535

Fax

(978) 068-3274

NPI assigned

Oct 18, 2006

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

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Intermountain Medical Group Grand Junction, LLCGroup PAC ID 3779707856, 297 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Intermountain Medical Group Grand Junction, LLC

  • Orthopaedic Surgery Physician
  • Grand Junction, CO
  • NPI 1356765556

  CO

  Medicare reassignment Care Compare group NPD
• Intermountain Medical Group Grand Junction, LLC

  • Foot & Ankle Surgery Podiatrist
  • Grand Junction, CO
  • NPI 1356835045
  Care Compare group
• Intermountain Medical Group Grand Junction, LLC

  • Durable Medical Equipment & Medical Supplies
  • Grand Junction, CO
  • NPI 1609737618
  NPD
• Sports & Orthopaedic Associates of the Redlands, LLC

  • Clinic/Center
  • Grand Junction, CO
  • NPI 1760466601
  NPD (past)
• St Mary'S Hospital and Medical Center, Inc

  • Hematology & Oncology Physician
  • Grand Junction, CO
  • NPI 1275714081
  NPD (past)

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474848000000",
    "number": "1316028129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "627 25 1/2 RD",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815056401",
            "telephone_number": "970-242-3535",
            "fax_number": "978-068-3274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "627 25 1/2 RD",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815056401",
            "telephone_number": "970-242-3535",
            "fax_number": "978-068-3274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITESIDES",
        "first_name": "BRYAN",
        "middle_name": "PAUL",
        "name_prefix": "Mr.",
        "credential": "MPT, OCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2016-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "PTL.0006022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mita White
• Taylor White I
• Elvera R. Whiteford, MD
• James David Whitehead, RN
• Sarah Michelle Whitehurst
• Wendy A Whitlock, D.C.
• Ashley E Whitney, NP
• Morgan Whittaker
• Ashton Tyner Whittle
• Christopher J Wibbelsman, MD

• All providers in Grand Junction, CO
• Physical Therapist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.