Individual provider Active NPI

Brianna Niquette, D.P.T.

  • Physical Therapist
  • Fort Pierce, FL
National Provider Identifier
1922475383
Registry record updated Apr 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT31672 Issued in FL
Practice address
800 Virginia Ave Ste 148
Fort Pierce, FL 34982-5829
Phone
(772) 464-6424
Fax
(724) 644-3247
NPI assigned
Sep 1, 2015
Last updated
Apr 14, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT31672 FL Primary

Addresses

Primary practice location

800 Virginia Ave Ste 148
Fort Pierce, FL 34982-5829

Mailing address

128 Pelican Island PL
Sebastian, FL 32958-6962
Phone (201) 704-8937

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210413000084 FL Practitioner - Physical Therapist in Private Practice 2961810999 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT31672FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Physical Therapy Sport Medicine Inc Physical Therapist CurrentSince Apr 5, 2021 Accepting new patients
Premier Physical Therapy & Sports Medicine Physical Therapist CurrentSince Apr 5, 2021 Accepting new patients
Premier Physical Therapy Sport Medicine Inc Physical Therapist Current Accepting new patients
Premier Physical Therapy Sport Medicine Inc Physical Therapist Past Accepting new patients

Locations

897 NE Jensen Beach Blvd
Jensen Beach, FL 34957
Phone (772) 324-3080

1400 SE Goldtree Dr
Ste 205
Port St Lucie, FL 34952

1345 36th St
Ste A
Vero Beach, FL 32960
Phone (772) 567-8040

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

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": "1441065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618358400000",
    "number": "1922475383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 PELICAN ISLAND PL",
            "city": "SEBASTIAN",
            "state": "FL",
            "postal_code": "329586962",
            "telephone_number": "201-704-8937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 VIRGINIA AVE STE 148",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349825829",
            "telephone_number": "772-464-6424",
            "fax_number": "724-644-3247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIQUETTE",
        "first_name": "BRIANNA",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-01",
        "last_updated": "2021-04-14",
        "certification_date": "2021-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT31672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Pierce, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2021; 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.