Individual provider Active NPI

Emily Brackenridge, MS, OTR/L

  • Occupational Therapist
  • Austin, TX
National Provider Identifier
1902138092
Registry record updated Nov 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
115404 Issued in TX
Practice address
321 W Ben White Blvd Ste 101
Austin, TX 78704-7086
Phone
(512) 215-9272
Fax
(512) 215-8934
NPI assigned
Feb 1, 2010
Last updated
Nov 16, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2021

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 115404 TX Primary

Addresses

Primary practice location

321 W Ben White Blvd Ste 101
Austin, TX 78704-7086

Mailing address

1033 La Posada Dr Ste 230
Austin, TX 78752-3842
Phone (512) 284-7192

Other identifiers 1

IdentifierTypeStateIssuer
115404OtherTXLICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Austin

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130628000272 TX Practitioner - Occupational Therapist in Private Practice 6204968076 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Endeavor Rehab Center IncGroup PAC ID 6800989369, 123 clinicians

Practice addresses (Care Compare)

6911 Ranch Rd 620
B 201
Austin, TX 78732-1920
Phone (512) 467-4546

Merit-based Incentive Payment System (MIPS)

Final score
74.64 of 100Reported as group
Quality
46.1
Promoting interoperability
92
Improvement activities
40
Cost
76.04

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Rehab Center Inc CurrentSince Jul 30, 2019 Accepting new patients
Endeavor Rehab Center Inc Occupational Therapist CurrentSince Jul 30, 2019 Accepting new patients

Locations

1033 La Posada Dr
Ste 230
Austin, TX 78752
Phone (512) 284-7192

321 W Ben White Blvd
Ste 101
Austin, TX 78704
Phone (512) 215-9272

3809 S 2nd St
Ste D100
Austin, TX 78704
Phone (512) 800-2569

6911 Ranch Road 620 N
Austin, TX 78732
Phone (512) 219-8533

5632 Edwards Ranch Rd
Ft Worth, TX 76109
Phone (817) 259-0600

896 Summit St
Round Rock, TX 78664
Phone (512) 599-4262

Organizations & group practices 2

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": "1264982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637020800000",
    "number": "1902138092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1033 LA POSADA DR STE 230",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787523842",
            "telephone_number": "512-284-7192",
            "fax_number": "512-284-7203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 W BEN WHITE BLVD STE 101",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787047086",
            "telephone_number": "512-215-9272",
            "fax_number": "512-215-8934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRACKENRIDGE",
        "first_name": "EMILY",
        "credential": "MS, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-01",
        "last_updated": "2021-11-16",
        "certification_date": "2021-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "115404",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "115404",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Austin",
            "affiliation": "N",
            "address_1": "321 W Ben White Blvd Ste 101",
            "city": "Austin",
            "state": "TX",
            "country_code": "US",
            "postal_code": "787047086",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2021; 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.