Brenda Ko, PT, RN

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

013279 Issued in NY

Practice address

973 James Street
3Rd Floor, Mist Office
Syracuse, NY 13203

Phone

(315) 458-7373

NPI assigned

Mar 29, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1711670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711670400000",
    "number": "1427809292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5008 WOODSIDE RD",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "130661748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "973 JAMES STREET",
            "address_2": "3RD FLOOR, MIST OFFICE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13203",
            "telephone_number": "315-458-7373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KO",
        "first_name": "BRENDA",
        "credential": "PT, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-29",
        "last_updated": "2024-03-29",
        "certification_date": "2024-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "NY",
            "license": "533953",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "013279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ana Knoblock
• Stephen J Knohl, MD
• Andrew Knoll, M.D.
• James L Knoll, M.D.
• Jessica Anne Knox, PT
• Timothy Allen Ko, RPA-C
• Hazar Kobayaa, M.D.
• Katsuhiro Kobayashi, M.D.
• Amanda Kobus, MA, RD, CDN
• Carolyn Bradley Koch, M.A., L.M.H.C.

• Physical Therapist in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2024; 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.