Individual provider Active NPI

Brittany Reynolds

  • Physical Therapy Assistant
  • Lubbock, TX
National Provider Identifier
1366026205
Registry record updated May 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2147149 Issued in TX
Practice address
6640 Iola Ave
Lubbock, TX 79424-7845
Phone
(806) 687-6840
NPI assigned
May 6, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2147149 TX Primary

Addresses

Primary practice location

6640 Iola Ave
Lubbock, TX 79424-7845

Mailing address

4533 77TH St
Lubbock, TX 79424-3201
Phone (806) 577-6022

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL HIPAA Direct

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

LicenseStateTypeSpecialty
2147149TXMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1620259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620259200000",
    "number": "1366026205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4533 77TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794243201",
            "telephone_number": "806-577-6022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6640 IOLA AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794247845",
            "telephone_number": "806-687-6840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "BRITTANY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-06",
        "last_updated": "2021-05-06",
        "certification_date": "2021-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2147149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "HIPAA",
            "affiliation": "N",
            "endpointDescription": "Patient Information",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6640 Iola Ave",
            "city": "Lubbock",
            "state": "TX",
            "country_code": "US",
            "postal_code": "794247845",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.