Individual provider Active NPI

Kristen Brininger, PTA

  • Physical Therapy Assistant
  • Raleigh, NC
National Provider Identifier
1649673542
Registry record updated Oct 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
A5284 Issued in NC
Practice address
3830 Blue Ridge Rd
Raleigh, NC 27612-4319
Phone
(919) 781-4900
NPI assigned
Oct 6, 2014
Last updated
Oct 6, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X A5284 NC Primary

Addresses

Primary practice location

3830 Blue Ridge Rd
Raleigh, NC 27612-4319

Mailing address

403 Laurens Way
Knightdale, NC 27545-7917
Phone (440) 228-4790

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
A5284NCMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1412553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412553600000",
    "number": "1649673542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 LAURENS WAY",
            "city": "KNIGHTDALE",
            "state": "NC",
            "postal_code": "275457917",
            "telephone_number": "440-228-4790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3830 BLUE RIDGE RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276124319",
            "telephone_number": "919-781-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRININGER",
        "first_name": "KRISTEN",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-06",
        "last_updated": "2014-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NC",
            "license": "A5284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2014; 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.