Dustin Ray Brisco, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5607 Issued in AZ

Practice address

2120 Airway Avenue
Kingman, AZ 86409-3027

Phone

(928) 757-1211

Fax

(928) 757-8826

NPI assigned

Oct 24, 2006

Last updated

Dec 5, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations (25 of 40)

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• BHSM Rehabilitation, LLC

  dba Banner Physical Therapy

  • Physical Therapy Clinic/Center
  • Buckeye, AZ
  • NPI 1467129684
  Medicare reassignment
• BHSM Rehabilitation LLC

  dba Banner Physical Therapy

  • Physical Therapy Clinic/Center
  • Maricopa, AZ
  • NPI 1366162877

  Physical Therapist

  NPD
• BHSM Rehabilitation, LLC

  dba Banner Physical Therapy

  • Physical Therapy Clinic/Center
  • Bullhead City, AZ
  • NPI 1093681033
  NPD
• BHSM Rehabilitation, LLC

  dba Banner Physical Therapy

  • Physical Therapy Clinic/Center
  • Gilbert, AZ
  • NPI 1497271431
  NPD
• BHSM Rehabilitation, LLC

  • Physical Therapy Clinic/Center
  • Glendale, AZ
  • NPI 1235654237
  NPD (past)
• BHSM Rehabilitation, LLC

  dba Banner Physical Therapy and Rehabilitation

  • Physical Therapy Clinic/Center
  • Peoria, AZ
  • NPI 1285271684
  NPD (past)

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228435200000",
    "number": "1538243183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2120 AIRWAY AVENUE",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864093027",
            "telephone_number": "928-757-1211",
            "fax_number": "928-757-8826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 AIRWAY AVENUE",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864093027",
            "telephone_number": "928-757-1211",
            "fax_number": "928-757-8826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRISCO",
        "first_name": "DUSTIN",
        "middle_name": "RAY",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2008-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "5607",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "755217",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elisha Bremmer, D.O.
• Thomas Dee Bress, LISAC
• Arlene Bridgers, LPN
• Brighter Heights Arizona, LLC Dba Hualapai Mountain
• Taz Aaron Brinkerhoff, MD
• Kimberly Ann Brisco, PT
• Julian Alexander Brix, DO
• Lanita Brixey, RPH
• Marie-There Yvonne Broca, O.D.
• Brock Chiropractic Inc PC

• Physical Therapist in Kingman, AZ
• Providers in Kingman, AZ by specialty
• Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2008; 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.