Brandon J Cridlebaugh, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT00010668 Issued in WA

Practice address

840 SE Bishop Blvd
Suite 200
Pullman, WA 99163-5502

Phone

(509) 338-9204

Fax

(509) 338-9206

NPI assigned

Aug 8, 2007

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 1

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Proformance Physical Therapy, LLCGroup PAC ID 0840229480, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Proformance Physical Therapy, LLC

  • Physical Therapist
  • Pullman, WA
  • NPI 1720012065
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1186531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186531200000",
    "number": "1346431863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 SE BISHOP BLVD",
            "address_2": "SUITE 200",
            "city": "PULLMAN",
            "state": "WA",
            "postal_code": "991635502",
            "telephone_number": "509-338-9204",
            "fax_number": "509-338-9206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 SE BISHOP BLVD",
            "address_2": "SUITE 200",
            "city": "PULLMAN",
            "state": "WA",
            "postal_code": "991635502",
            "telephone_number": "509-338-9204",
            "fax_number": "509-338-9206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRIDLEBAUGH",
        "first_name": "BRANDON",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-08",
        "last_updated": "2007-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00010668",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPIST",
            "identifier": "PT00010668",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kami Kate Cornwall, LMHC
• Melissa Ann Cox, LMP
• Steven Cox
• Sherry Craft
• Matthew Crahan
• Nicholas Cromidas
• Amy June Crow
• Anna Curet
• Kenneth H Cyr, D.C.
• Amya Josephine Dahl

• Physical Therapist in Pullman, WA
• Providers in Pullman, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2007; 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.