Jaclyn Brady, DPT

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

License

PT016401 Issued in OH

Practice address

306 E Whittier Ave
Fairborn, OH 45324-5313

Phone

(937) 878-3961

Fax

(937) 879-8180

NPI assigned

Nov 3, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Fairborn City School District

  • Local Education Agency (LEA)
  • Fairborn, OH
  • NPI 1861695827
  NPD (past)

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

{
    "created_epoch": "1478131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478131200000",
    "number": "1841742012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 E WHITTIER AVE",
            "city": "FAIRBORN",
            "state": "OH",
            "postal_code": "453245313",
            "telephone_number": "937-878-3961",
            "fax_number": "937-879-8180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 E WHITTIER AVE",
            "city": "FAIRBORN",
            "state": "OH",
            "postal_code": "453245313",
            "telephone_number": "937-878-3961",
            "fax_number": "937-879-8180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADY",
        "first_name": "JACLYN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-03",
        "last_updated": "2016-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "OH",
            "license": "PT016401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynchelle Boston
• Jalyn Boston
• Anna Bowers
• Christopher Bowman, PHARMD
• Sydney Bowser
• Zoe Brandon, BSW
• Mondrace J Brantley
• Stacey Ann Braun
• Nicea Bray
• Dominique Briggs

• Pediatric Physical Therapist in Fairborn, OH
• Providers in Fairborn, OH by specialty
• Pediatric Physical Therapist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2016; 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.