Brandi Renfro, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT30252 Issued in FL

Practice address

78 Sunburst CT
Ponte Vedra, FL 32081-0147

Phone

(405) 815-9494

Fax

(405) 454-0030

NPI assigned

Jun 4, 2014

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

Enrolled in FL

Enrollment records 1

Medicare enrollment (NPD)

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.

• Move Mobile Therapy LLC

  • Physical Therapy Clinic/Center
  • Ponte Vedra, FL
  • NPI 1649817206
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1401840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587081600000",
    "number": "1912310285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78 SUNBURST CT",
            "city": "PONTE VEDRA",
            "state": "FL",
            "postal_code": "320810147",
            "telephone_number": "405-815-9494",
            "fax_number": "405-454-0030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "78 SUNBURST CT",
            "city": "PONTE VEDRA",
            "state": "FL",
            "postal_code": "320810147",
            "telephone_number": "405-815-9494",
            "fax_number": "405-454-0030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENFRO",
        "first_name": "BRANDI",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-04",
        "last_updated": "2020-04-17",
        "certification_date": "2020-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT30252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nasrin Datar Raina, M.D.
• Christina Marie Ralko, CPNP-PC
• Travis Raulerson, MA
• Alice Whitson Regan, RPH
• Kathryn Pray Reneau, LCSW
• Sabrina Rensink
• Revision Health Services, PLLC
• Sharina Shantel Richardson
• Rise Psychiatric LLC
• Lyndsey Ritchie

• Physical Therapist in Ponte Vedra, FL
• Providers in Ponte Vedra, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2020; 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.