Bryan Federico, DOCTOR OF PHYSICAL T

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

05146R Issued in LA

Practice address

907 Buffalo St
Johnson City, TN 37604-6719

Phone

(423) 430-6611

Fax

(423) 815-1051

NPI assigned

Nov 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Federico Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Johnson City, TN
  • NPI 1760286520

  Physical Therapist

  Medicare reassignment NPD Authorized official
• Independent Physical Therapy, LLC

  • Physical Therapist
  • Chattanooga, TN
  • NPI 1104878354
  Medicare reassignment NPD
• Watauga Orthopaedics PLC

  • Orthopaedic Surgery Physician
  • Johnson City, TN
  • NPI 1245251404

  Physical Therapist

  Medicare reassignment NPD
• Watauga Orthopaedics, PLC

  • Durable Medical Equipment & Medical Supplies
  • Greeneville, TN
  • NPI 1730924192

  Physical Therapist

  NPD
• Wellmont Medical Associates Inc

  • Family Medicine Physician
  • Big Stone Gap, VA
  • NPI 1174808216
  NPD (past)

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764633600000",
    "number": "1689741639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "907 BUFFALO ST",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046719",
            "telephone_number": "423-430-6611",
            "fax_number": "423-815-1051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "907 BUFFALO ST",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046719",
            "telephone_number": "423-430-6611",
            "fax_number": "423-815-1051"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "420 Railroad St",
            "address_purpose": "LOCATION",
            "city": "Elizabethton",
            "state": "TN",
            "postal_code": "376432504",
            "country_code": "US",
            "telephone_number": "423-297-1813",
            "fax_number": "423-297-1815",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FEDERICO",
        "first_name": "BRYAN",
        "name_prefix": "Mr.",
        "credential": "DOCTOR OF PHYSICAL T",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2025-12-02",
        "certification_date": "2025-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "05146R",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "8823",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "12513",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY LICENSE",
            "identifier": "05146R",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "0000012513",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charles Faust, RDH
• Brandon Justin Fazalare, MD
• Grant Michael Feathers, PHARMD
• Jessie P Feathers, MD
• Federico Physical Therapy, LLC
• Richard A Feit, M.D.
• Fellowship Physical Therapy LLC
• Brad A Feltis, MD
• James Eric Feltman, LPC-MHSP
• Micah Feltner, DO

• Physical Therapist in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Physical Therapist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.