Individual provider Active NPI

Danielle Brachman, DPT

  • Orthopedic Physical Therapist
  • Boise, ID
National Provider Identifier
1346589314
Registry record updated Feb 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
PTL-0012063 Issued in CO
Practice address
7550 W Emerald St
Boise, ID 83704-9015
Phone
(208) 375-0666
Fax
(208) 375-2996
NPI assigned
Feb 11, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X PTL-0012063 CO Primary

Addresses

Primary practice location

7550 W Emerald St
Boise, ID 83704-9015

Mailing address

7550 W Emerald St
Boise, ID 83704-9015
Phone (208) 375-0666

Other names 1

  • Ms. Danielle Bannon Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190109000482 IA Practitioner - Physical Therapist in Private Practice 6002053865 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jason J. Putz Physical Therapy P.C.Group PAC ID 2769578657, 18 clinicians

Practice addresses (Care Compare)

107 S 11TH St
Suite 1
Manchester, IA 52057-2220
Phone (563) 927-1499

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PTL-0012063COMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Jason J. Putz Physical Therapy P.C. CurrentSince Oct 22, 2018 Accepting new patients
McCall Physical Therapy, P.a. Past Accepting new patients
Performax Front Range Physical Therapy LLC Orthopedic Past Accepting new patients

Locations

1129 11th St SE
Ste A
Dyersville, IA 52040
Phone (563) 875-8615

107 S 11th St
Ste 1
Manchester, IA 52057
Phone (563) 927-1499

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1360540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360540800000",
    "number": "1346589314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7550 W EMERALD ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837049015",
            "telephone_number": "208-375-0666",
            "fax_number": "208-375-2996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7550 W EMERALD ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837049015",
            "telephone_number": "208-375-0666",
            "fax_number": "208-375-2996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRACHMAN",
        "first_name": "DANIELLE",
        "name_prefix": "Mrs.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-11",
        "last_updated": "2013-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CO",
            "license": "PTL-0012063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANIELLE",
            "last_name": "BANNON",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2013; 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.