Brianne M Williams, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

13105-24 Issued in WI

Practice address

1000 Midway Rd
Menasha, WI 54952-1116

Phone

(920) 727-9878

NPI assigned

Oct 20, 2016

Last updated

Jan 20, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Brianne MW Vandyke Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1476921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611100800000",
    "number": "1467903849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 CONGRESS PL",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549562946",
            "telephone_number": "920-205-4840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 MIDWAY RD",
            "city": "MENASHA",
            "state": "WI",
            "postal_code": "549521116",
            "telephone_number": "920-727-9878"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6001 Research Park Blvd",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537191176",
            "country_code": "US",
            "telephone_number": "920-205-4840",
            "fax_number": "608-262-9246",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "BRIANNE",
        "middle_name": "M",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-20",
        "last_updated": "2021-01-20",
        "certification_date": "2021-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "13105-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRIANNE",
            "last_name": "VANDYKE",
            "middle_name": "MW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physical Therapist in Menasha, WI
• Providers in Menasha, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 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.