Individual provider Active NPI

Joshua Bruinsma

  • Physical Therapy Assistant
  • Hillsborough, NC
National Provider Identifier
1972841096
Registry record updated Dec 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2138 Issued in CT
Practice address
2916 Yates Rd
Hillsborough, NC 27278
Phone
(860) 559-8035
NPI assigned
Jan 24, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2138 CT Primary
Physical Therapy Assistant 225200000X A4991 NC

Addresses

Primary practice location

2916 Yates Rd
Hillsborough, NC 27278

Mailing address

49 Venice Dr
Burlington, CT 06013-2509

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
A4991NCMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1358985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608595200000",
    "number": "1972841096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 VENICE DR",
            "city": "BURLINGTON",
            "state": "CT",
            "postal_code": "060132509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2916 YATES RD",
            "city": "HILLSBOROUGH",
            "state": "NC",
            "postal_code": "27278",
            "telephone_number": "860-559-8035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUINSMA",
        "first_name": "JOSHUA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-01-24",
        "last_updated": "2020-12-22",
        "certification_date": "2020-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CT",
            "license": "2138",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NC",
            "license": "A4991",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hillsborough, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2020; 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.