Active NPI
Danielle Brachman, DPT
- Orthopedic Physical Therapist
- Boise, ID
National Provider Identifier
1346589314
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- PTL-0012063
- 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
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 |
|---|---|---|---|---|
| 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
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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.
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
| License | State | Type | Specialty |
|---|---|---|---|
| PTL-0012063 | CO | MD | Orthopedic Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jason J. Putz Physical Therapy P.C. | Current | 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.
-
- Physical Therapist
- McCall, ID
- NPI 1750454104
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.