Individual provider Active NPI

Emily K Bruckner, DPT

  • Physical Therapist
  • Grove City, OH
National Provider Identifier
1639935083
Registry record updated Feb 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT020891 Issued in OH
Practice address
5500 N Meadows Dr
Grove City, OH 43123-7687
Phone
(614) 488-1816
Fax
(614) 488-0390
NPI assigned
Feb 23, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2024

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 PT020891 OH Primary

Addresses

Primary practice location

5500 N Meadows Dr
Grove City, OH 43123-7687

Mailing address

PO Box 920120
Dallas, TX 75392-0120

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240403004236 OH Practitioner - Physical Therapist in Private Practice 8820436280 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT020891OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic One, Inc CurrentSince Feb 13, 2024 Accepting new patients
Orthopedic One, Inc CurrentSince Feb 13, 2024 Accepting new patients
Orthopedic One, Inc. Current Accepting new patients

Locations

5500 N Meadows Dr
Grove City, OH 43123
Phone (614) 488-1816

4604 Sawmill Rd
Upper Arlngtn, OH 43220
Phone (614) 839-2300

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": "1708646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708646400000",
    "number": "1639935083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 920120",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753920120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 N MEADOWS DR",
            "city": "GROVE CITY",
            "state": "OH",
            "postal_code": "431237687",
            "telephone_number": "614-488-1816",
            "fax_number": "614-488-0390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUCKNER",
        "first_name": "EMILY",
        "middle_name": "K",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-23",
        "last_updated": "2024-02-23",
        "certification_date": "2024-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT020891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grove City, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2024; 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.