Individual provider Active NPI

Brian A Libel, PT

  • Specialist
  • Saint Joseph, MO
National Provider Identifier
1073572988
Registry record updated Jul 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
1999135044 Issued in MO
Practice address
3107 Frederick Ave
Saint Joseph, MO 64506-2911
Phone
(816) 233-9555
Fax
(816) 279-1423
NPI assigned
Mar 20, 2006
Last updated
Jul 23, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 1999135044 MO Primary

Addresses

Primary practice location

3107 Frederick Ave
Saint Joseph, MO 64506-2911

Mailing address

3107 Frederick Ave
Lower Level
Saint Joseph, MO 64506-2911
Phone (816) 233-9555

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
1999135044MOMDSpecialist

Organizations & group practices 1

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": "1142812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216771200000",
    "number": "1073572988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3107 FREDERICK AVE",
            "address_2": "LOWER LEVEL",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645062911",
            "telephone_number": "816-233-9555",
            "fax_number": "816-279-1423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3107 FREDERICK AVE",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645062911",
            "telephone_number": "816-233-9555",
            "fax_number": "816-279-1423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIBEL",
        "first_name": "BRIAN",
        "middle_name": "A",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-20",
        "last_updated": "2008-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MO",
            "license": "1999135044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MO

Sources for this page

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