Individual provider Active NPI

Mark E Brooks, PT, DSC, ECS, OCS

  • Clinical Electrophysiology Physical Therapist
  • Richmond, KY
National Provider Identifier
1003807819
Registry record updated Dec 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Electrophysiology Physical TherapistTaxonomy code 2251E1300X
License
001746 Issued in KY
Practice address
312 Jason Dr Ste 5
Richmond, KY 40475-2785
Phone
(859) 625-0001
NPI assigned
Nov 1, 2005
Last updated
Dec 2, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT38134 FL
Physical Therapist 225100000X 001746 KY
Clinical Electrophysiology Physical Therapist 2251E1300X 001746 KY Primary

Addresses

Primary practice location

312 Jason Dr Ste 5
Richmond, KY 40475-2785

Mailing address

312 Jason Dr Ste 5
Richmond, KY 40475-2785
Phone (859) 625-0001

Other practice location 1

116 Meridian Way Ste 9
Richmond, KY 40475-2876
Phone (859) 626-3131

Other practice location 2

13550 S Jog Rd Ste 100
Delray Beach, FL 33446-3808
Phone (561) 496-5144

Other identifiers 10

IdentifierTypeStateIssuer
000000333709OtherKYBC/BS HPTA
611208897OtherKYWORKERS COMP.
611208897OtherKYAETNA
87000006MedicaidKY
000000215122OtherKYBC/BS SPTA
611208897OtherKYHUMANA
611208897OtherKYTRICARE
000000310944OtherKYBC/BS RPTA
611208897OtherKYBLUEGRASS FAMILY
000000060027OtherKYBC/BS LPTA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040401000119 KY Practitioner - Physical Therapist in Private Practice 9739076837 Reassigns benefits to 2 organizations
I20170824002448 IN Practitioner - Physical Therapist in Private Practice 9739076837 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Professional Rehabilitation Associates, PSCGroup PAC ID 3072400167, 2 clinicians

Practice addresses (Care Compare)

116 Meridian Way
Suite 9
Richmond, KY 40475-2876
Phone (859) 625-3131

312 Jason Dr
Suite 5
Richmond, KY 40475-2785
Phone (859) 625-0001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT38134FLMDPhysical Therapist
001746KYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Taylor Regional Medical Group LLC CurrentSince Jan 10, 2019 Accepting new patients
Taylor Regional Medical Group,LLC CurrentSince Jan 10, 2019 Accepting new patients
Jackson Physical Therapy & Associates, Inc Physical Therapist CurrentSince Aug 8, 2017 Accepting new patients

Locations

326 N Indiana Ave
Sellersburg, IN 47172
Phone (812) 246-8975

1698 Old Lebanon Rd
Campbellsvlle, KY 42718
Phone (270) 465-3561

1700 Old Lebanon Rd
Campbellsvlle, KY 42718
Phone (270) 465-3561

73 Kingswood Dr
Campbellsvlle, KY 42718
Phone (270) 789-1112

Organizations & group practices 5

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": "1130803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764633600000",
    "number": "1003807819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 JASON DR STE 5",
            "city": "RICHMOND",
            "state": "KY",
            "postal_code": "404752785",
            "telephone_number": "859-625-0001",
            "fax_number": "859-625-1109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 JASON DR STE 5",
            "city": "RICHMOND",
            "state": "KY",
            "postal_code": "404752785",
            "telephone_number": "859-625-0001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "116 Meridian Way Ste 9",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "KY",
            "postal_code": "404752876",
            "country_code": "US",
            "telephone_number": "859-626-3131",
            "fax_number": "859-625-1109",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13550 S Jog Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Delray Beach",
            "state": "FL",
            "postal_code": "334463808",
            "country_code": "US",
            "telephone_number": "561-496-5144",
            "fax_number": "561-496-5201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "MARK",
        "middle_name": "E",
        "credential": "PT, DSC, ECS, OCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-01",
        "last_updated": "2025-12-02",
        "certification_date": "2025-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT38134",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "001746",
            "primary": false
        },
        {
            "code": "2251E1300X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Electrophysiology, Clinical",
            "state": "KY",
            "license": "001746",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS HPTA",
            "identifier": "000000333709",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKERS COMP.",
            "identifier": "611208897",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "611208897",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "87000006",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS SPTA",
            "identifier": "000000215122",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "611208897",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "611208897",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS RPTA",
            "identifier": "000000310944",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUEGRASS FAMILY",
            "identifier": "611208897",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS LPTA",
            "identifier": "000000060027",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2025; 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.