Individual provider Active NPI

Benjamin John Brightman, OTRL

  • Occupational Therapist
  • Nashville, NC
National Provider Identifier
1821293457
Registry record updated Aug 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5333 Issued in NC
Practice address
143 Nashville Commons Dr
Nashville, NC 27856-1823
Phone
(252) 459-5565
Fax
(252) 459-5568
NPI assigned
Jun 14, 2007
Last updated
Aug 3, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 5333 NC Primary

Addresses

Primary practice location

143 Nashville Commons Dr
Nashville, NC 27856-1823

Mailing address

PO Box 7594
Rocky Mount, NC 27804-0594
Phone (252) 443-9103

Other identifiers 2

IdentifierTypeStateIssuer
7301714MedicaidNC
136KYOtherNCBCBS NC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170728002438 NY Practitioner - Occupational Therapist in Private Practice 0840275632 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5719 Widewaters Pkwy
Syracuse, NY 13214-1985
Phone (315) 251-3100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
012226NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Syracuse Orthopedic Specialists, PLLC CurrentSince Jul 1, 2017 Accepting new patients
Seco Physical & Occupational Therapy PLLC PastSince May 1, 2015 Accepting new patients
Syracuse Orthopedic Specialists, PLLC Past Accepting new patients
Seco Occupational Therapy PC Occupational Therapist Past Accepting new patients

Locations

8324 Oswego Rd
Ste A
Liverpool, NY 13090
Phone (315) 418-4128

5719 Widewaters Pkwy
Syracuse, NY 13214
Phone (315) 251-3110

Interoperability endpoints

  • Direct secure messaging: bbrightman@sosbones.medentdirect.com

Organizations & group practices 4

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": "1181779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312329600000",
    "number": "1821293457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7594",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278040594",
            "telephone_number": "252-443-9103",
            "fax_number": "252-451-9032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 NASHVILLE COMMONS DR",
            "city": "NASHVILLE",
            "state": "NC",
            "postal_code": "278561823",
            "telephone_number": "252-459-5565",
            "fax_number": "252-459-5568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIGHTMAN",
        "first_name": "BENJAMIN",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "OTRL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-14",
        "last_updated": "2011-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "5333",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7301714",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC",
            "identifier": "136KY",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2011; 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.