Individual provider Active NPI

Brendan Scott Owsley, PTA

  • Physical Therapy Assistant
  • Camdenton, MO
National Provider Identifier
1003446584
Registry record updated Jan 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2019039394 Issued in MO
Practice address
1930 N Business Route 5 Unit 1B
Camdenton, MO 65020-2659
Phone
(573) 346-7445
NPI assigned
Jan 23, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2019039394 MO Primary

Addresses

Primary practice location

1930 N Business Route 5 Unit 1B
Camdenton, MO 65020-2659

Mailing address

1930 N Business Route 5 Unit 1B
Camdenton, MO 65020-2659
Phone (573) 346-7445

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
2019039394MOMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1579737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579737600000",
    "number": "1003446584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 N BUSINESS ROUTE 5 UNIT 1B",
            "city": "CAMDENTON",
            "state": "MO",
            "postal_code": "650202659",
            "telephone_number": "573-346-7445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 N BUSINESS ROUTE 5 UNIT 1B",
            "city": "CAMDENTON",
            "state": "MO",
            "postal_code": "650202659",
            "telephone_number": "573-346-7445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWSLEY",
        "first_name": "BRENDAN",
        "middle_name": "SCOTT",
        "name_prefix": "Mr.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-01-23",
        "last_updated": "2020-01-23",
        "certification_date": "2020-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MO",
            "license": "2019039394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camdenton, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 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.