Bryan James Brockett, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1590 Issued in NV

Practice address

5546 S Fort Apache Rd Ste 200
Las Vegas, NV 89148-7692

Phone

(702) 947-9994

Fax

(702) 947-9998

NPI assigned

Aug 18, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Chynoweth Hill and Leavitt LLC

  • Physical Therapist
  • Pahrump, NV
  • NPI 1700878444
  NPD (past)

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397779200000",
    "number": "1699767335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 HANSON ST",
            "city": "WINNEMUCCA",
            "state": "NV",
            "postal_code": "894453607",
            "telephone_number": "775-625-2222",
            "fax_number": "775-625-1131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5546 S FORT APACHE RD STE 200",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891487692",
            "telephone_number": "702-947-9994",
            "fax_number": "702-947-9998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCKETT",
        "first_name": "BRYAN",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-18",
        "last_updated": "2014-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "1590",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "NV1590",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100503507",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jamisha Brock
• Jazmin Danielle Brock
• Katherine Dawn Brock
• Mariah Jo-Ellen Brock
• Vivien Brock
• William Brockington
• Geoffery M Brockman, LMT
• Roselyn Mendez Brockschmidt
• Heather Lynn Brockway, LSW
• Brockwell Healthcare LLC

• Physical Therapist in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Physical Therapist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 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.