Federico Physical Therapy, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

FEDERICO PHYSICAL THERAPY, LLC

Practice address

108 E 10TH Ave Ste 2
Johnson City, TN 37601-3925

Phone

(423) 430-6611

Fax

(423) 815-1051

NPI assigned

Apr 2, 2025

Organization subpart

No

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

Authorized official

Name

Bryan Federico, DPTNPI 1689741639

Title

Owner/Clinician

Phone

(423) 430-6611

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Bryan Federico, DOCTOR OF PHYSICAL T

  • Physical Therapist
  • Johnson City, TN
  • NPI 1689741639
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1743552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743552000000",
    "number": "1760286520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 E 11TH AVE",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376013928",
            "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": "108 E 10TH AVE STE 2",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376013925",
            "telephone_number": "423-430-6611",
            "fax_number": "423-815-1051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FEDERICO PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-02",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A",
        "authorized_official_last_name": "FEDERICO",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "OWNER/CLINICIAN",
        "authorized_official_telephone_number": "423-430-6611",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olivia Fast, DMD
• Charles Faust, RDH
• Brandon Justin Fazalare, MD
• Grant Michael Feathers, PHARMD
• Jessie P Feathers, MD
• Bryan Federico, DOCTOR OF PHYSICAL T
• Richard A Feit, M.D.
• Fellowship Physical Therapy LLC
• Brad A Feltis, MD
• James Eric Feltman, LPC-MHSP

• Physical Therapy Clinic/Center in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Physical Therapy Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.