Individual provider Active NPI

Brenna Canterbury, DPT

  • Physical Therapist
  • Flagstaff, AZ
National Provider Identifier
1699057091
Registry record updated Aug 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
LPT-009484 Issued in AZ
Practice address
1840 N Jasper Dr Ste 3
Flagstaff, AZ 86001-1634
Phone
(866) 974-2673
Fax
(866) 939-2673
NPI assigned
Sep 13, 2011
Last updated
Aug 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 05008976A IN
Physical Therapist 225100000X 9484 AZ
Physical Therapist 225100000X LPT-009484 AZ Primary

Addresses

Primary practice location

1840 N Jasper Dr Ste 3
Flagstaff, AZ 86001-1634

Mailing address

18444 N 25TH Ave Ste 310
Phoenix, AZ 85023-1266
Phone (623) 241-8706

Other practice location 1

18444 N 25th Ave Ste 220
Phoenix, AZ 85023-1264
Phone (866) 974-2673

Other identifiers 1

IdentifierTypeStateIssuer
643343MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, AZ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20111017000763 TX Practitioner - Physical Therapist in Private Practice 4688846660 Reassigns benefits to 1 organization
I20230815002297 AZ Practitioner - Physical Therapist in Private Practice 4688846660 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1840 N Jasper Dr
Suite 3
Flagstaff, AZ 86001-1634
Phone (866) 974-2673

Merit-based Incentive Payment System (MIPS)

Final score
85.65 of 100Reported as group
Quality
76.23
Promoting interoperability
100
Improvement activities
40
Cost
75.95

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
05008976AINMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Orthopedic Research and Education LLC CurrentSince Jul 7, 2023 Accepting new patients
Winslow Indian Health Care Center, Inc CurrentSince Sep 14, 2011 Accepting new patients
Dilkon Medical Center Current Accepting new patients
Center for Orthopedic Research and Education, LLC Physical Therapist CurrentSince Jul 7, 2023 Accepting new patients
Winslow Indian Health Care Center, Inc CurrentSince Sep 14, 2011 Accepting new patients

Locations

1840 N Jasper Dr
Ste 3
Flagstaff, AZ 86001

18444 N 25th Ave
Ste 220
Phoenix, AZ 85023
Phone (669) 742-6738

18444 N 25th Ave
Ste 310
Phoenix, AZ 85023
Phone (623) 241-8706

10494 W Thunderbird Blvd
Ste 102
Sun City, AZ 85351
Phone (623) 975-8311

1527 N Park Dr
Winslow, AZ 86047

500 Indiana Ave
Winslow, AZ 86047

Interoperability endpoints

  • Direct secure messaging: brenna.canterbury.1@22724.direct.athenahealth.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1315872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754956800000",
    "number": "1699057091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18444 N 25TH AVE STE 310",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850231266",
            "telephone_number": "623-241-8706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1840 N JASPER DR STE 3",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860011634",
            "telephone_number": "866-974-2673",
            "fax_number": "866-939-2673"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18444 N 25th Ave Ste 220",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850231264",
            "country_code": "US",
            "telephone_number": "866-974-2673",
            "fax_number": "866-939-2673",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CANTERBURY",
        "first_name": "BRENNA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-13",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05008976A",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "9484",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "LPT-009484",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "643343",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flagstaff, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.