Waverly Ann Dixon, PT
Individual provider Active NPI Physical Therapist · Brookfield, MO
NPI 1043315484 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1043315484
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 110262 (MO)
- Practice address
- 223 N Main St
Brookfield, MO 64628-1628 - Phone
- (660) 258-7892
- Fax
- (660) 258-9828
- NPI assigned
- Sep 13, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Malloy Holdings, LLC | Past | Accepting new patients | |
| Brookfield Physical Therapy,Inc. | Physical Therapist | Past |
Accepting new patients |
| Covenant Rehab Clinic, LLC | Physical Therapist | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 110262 | MO | Yes |
Addresses
Primary practice location
223 N Main St
Brookfield, MO 64628-1628
Mailing address
223 N Main St
Brookfield, MO 64628-1628
Phone (660) 258-7892
Other providers in Brookfield, MO
- Amy Creason
- Creative Pathways Residential Supports
- Michael R Crist
- Alejandro S Curiel
- Jennifer Anne Dixon
- David Loris Dollins
- Uraina Domon
- Dennis Craig Engquist Sr.
- Heather Jo Evans
- Denise Ewing
All providers in Brookfield, MO · Physical Therapist in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.