Active NPI
Steven Allen Brown, PTA
- Physical Therapy Assistant
- Payette, ID
National Provider Identifier
1043477979
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 7943
- Practice address
- 327 S 20TH St
Payette, ID 83661-3033 - Phone
- (208) 453-1522
- Fax
- (208) 453-1591
- NPI assigned
- May 19, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 8620 | OR | |
| Physical Therapy Assistant | 225200000X | PTA-179 | ID | |
| Physical Therapy Assistant | 225200000X | 7943 | TN | Primary |
Addresses
Primary practice location
327 S 20TH St
Payette, ID 83661-3033
Mailing address
311 Carter St Apt 213
Nashville, TN 37210-5355
Phone (208) 600-9013
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PTA-8620 | Other | OR | STATE OF OREGON |
| PTA-179 | Other | ID | IDAHO LICENSE NUMBER |
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
| License | State | Type | Specialty |
|---|---|---|---|
| PTA-179 | ID | MD | Physical Therapy Assistant |
| 8620 | OR | MD | Physical Therapy Assistant |
| 7943 | TN | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211155200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1631836800000",
"number": "1043477979",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "311 CARTER ST APT 213",
"city": "NASHVILLE",
"state": "TN",
"postal_code": "372105355",
"telephone_number": "208-600-9013",
"fax_number": "208-600-9013"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "327 S 20TH ST",
"city": "PAYETTE",
"state": "ID",
"postal_code": "836613033",
"telephone_number": "208-453-1522",
"fax_number": "208-453-1591"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROWN",
"first_name": "STEVEN",
"middle_name": "ALLEN",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-05-19",
"last_updated": "2021-09-17",
"certification_date": "2021-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "OR",
"license": "8620",
"primary": false
},
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "ID",
"license": "PTA-179",
"primary": false
},
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "TN",
"license": "7943",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF OREGON",
"identifier": "PTA-8620",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IDAHO LICENSE NUMBER",
"identifier": "PTA-179",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Payette, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.