Individual provider Active NPI

Kenzie Lynn Brinkley

  • Physical Therapist
  • Lubbock, TX
National Provider Identifier
1447726799
Registry record updated Mar 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1306950 Issued in TX
Practice address
3838 50TH St
Lubbock, TX 79413-3808
Phone
(806) 792-5522
Fax
(806) 785-7582
NPI assigned
Oct 15, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1306950 TX Primary

Addresses

Primary practice location

3838 50TH St
Lubbock, TX 79413-3808

Mailing address

3838 50TH St
Lubbock, TX 79413-3808
Phone (806) 792-5522

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190208001697 TX Practitioner - Physical Therapist in Private Practice 4789922246 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1306950TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Grace Clinic of Lubbock Physical Therapist CurrentSince Mar 1, 2022 Accepting new patients
Physical Therapy Associates, LP Physical Therapist CurrentSince May 6, 2021 Accepting new patients
Grace Clinic of Lubbock CurrentSince Mar 1, 2022 Accepting new patients

Locations

3838 50th St
Lubbock, TX 79413
Phone (806) 792-5522

4515 Marsha Sharp Fwy
Lubbock, TX 79407
Phone 80674472232432

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": "1539561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648080000000",
    "number": "1447726799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3838 50TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794133808",
            "telephone_number": "806-792-5522",
            "fax_number": "806-785-7582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3838 50TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794133808",
            "telephone_number": "806-792-5522",
            "fax_number": "806-785-7582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRINKLEY",
        "first_name": "KENZIE",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-15",
        "last_updated": "2022-03-24",
        "certification_date": "2022-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1306950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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 Mar 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.