Brittany N Ellis, DPT
Individual provider Active NPI Physical Therapist · Johnson City, TN
NPI 1508488115 · NPPES record last updated May 10, 2024
Key facts
- NPI
- 1508488115
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 12713 (TN)
- Practice address
- 2410 Susannah St
Johnson City, TN 37601-1748 - Phone
- (423) 282-9011
- Fax
- (423) 282-0035
- NPI assigned
- May 18, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Watauga Orthopaedics PLC
Practice addresses (Care Compare)
2410 Susannah St
Johnson City, TN 37601-1748
Phone (423) 282-9011
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200526002026 | TN | Practitioner - Physical Therapist in Private Practice | 9436570652 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12713 | TN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Watauga Orthopaedics PLC | Physical Therapist | Current |
Accepting new patients |
| Watauga Orthopaedics, PLC | Physical Therapist | Current |
Accepting new patients |
| Watauga Orthopaedics, PLC | Physical Therapist | Past | Accepting new patients |
| PT Solutions LLC | Physical Therapist | Past |
Accepting new patients |
Locations
340 Steeles Rd
Bristol, TN 37620
Phone (423) 282-9011
2412 Susannah St
Johnson City, TN 37601
Phone (423) 282-8070
2410 Susannah St
Johnson City, TN 37601
Phone (423) 282-9011
875 Larry Neil Way
Kingsport, TN 37660
Phone (423) 282-9011
Interoperability endpoints
- https://api.platform.athenahealth.com/3374/brand/1/csg/1/fhir/r4
- brittany.gray.1@3374.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 12713 | TN | Yes |
Addresses
Primary practice location
2410 Susannah St
Johnson City, TN 37601-1748
Mailing address
2410 Susannah St
Johnson City, TN 37601-1748
Phone (423) 282-9011
Other practice location 1
875 Larry Neil Way
Kingsport, TN 37660-6368
Phone (423) 282-9011
Other practice location 2
340 Steeles Rd
Bristol, TN 37620-9532
Phone (423) 282-9011
Other names
- Miss Brittany N Gray
Other providers in Johnson City, TN
- Haley Elizabeth Elliott
- Jeremy Nathan Elliott
- Lillie Grace Elliott
- Payge Elliott
- Sterlin Elliott
- Jon B Ellis
- Kenneth Ray Ellis
- Meg Williams Ellis
- Milton Keith Ellis
- Madison B. Ellison
All providers in Johnson City, TN · Physical Therapist in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 10, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.