Dale B Brockman, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

000000010141 Issued in KY

Practice address

13 Oblique St
Florence, KY 41042-1927

Phone

(859) 371-1929

Fax

(859) 371-2581

NPI assigned

Sep 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210636800000",
    "number": "1043318371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 OBLIQUE ST",
            "city": "FLORENCE",
            "state": "KY",
            "postal_code": "410421927",
            "telephone_number": "859-371-1929",
            "fax_number": "859-371-2581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 OBLIQUE ST",
            "city": "FLORENCE",
            "state": "KY",
            "postal_code": "410421927",
            "telephone_number": "859-371-1929",
            "fax_number": "859-371-2581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCKMAN",
        "first_name": "DALE",
        "middle_name": "B",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2008-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "000000010141",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "87015004",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• C Michael Brinker, DMD PSC
• Nicholas Brinkman
• Brinsko Psychological Services Inc
• Beth E Brinsko, PH.D.
• Christina Lynn Brock, MA,CCC-SLP
• Todd M Brockman, PT, MS, DPT
• Eva Kristin Broeg, D.C.
• Richard A. Broeg, D.C.
• Wantina Wynette Brooks-Roach, LCPM
• Kaitlyn Brooks, LCSW

• Physical Therapist in Florence, KY
• Providers in Florence, KY by specialty
• Physical Therapist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2008; 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.