Individual provider Active NPI

Brady Burks, OTR

  • Occupational Therapist
  • San Angelo, TX
National Provider Identifier
1083246755
Registry record updated Feb 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
120585 Issued in TX
Practice address
3001 S Jackson St
San Angelo, TX 76904-5129
Phone
(325) 223-6300
NPI assigned
Feb 10, 2020
Last updated
Feb 10, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 120585 TX Primary

Addresses

Primary practice location

3001 S Jackson St
San Angelo, TX 76904-5129

Mailing address

3001 S Jackson St
San Angelo, TX 76904-5129

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210513002223 TX Practitioner - Occupational Therapist in Private Practice 6800205303 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The West Texas Rehabilitation Center CurrentSince Apr 28, 2021 Accepting new patients
The West Texas Rehabilitation Center CurrentSince Apr 28, 2021 Accepting new patients
The West Texas Rehabilitation Center Occupational Therapist Current Accepting new patients

Locations

4601 Hartford St
Abilene, TX 79605
Phone (325) 793-3400

3001 S Jackson St
San Angelo, TX 76904
Phone (325) 223-6300

Organizations & group practices 3

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": "1581292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581292800000",
    "number": "1083246755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 S JACKSON ST",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769045129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 S JACKSON ST",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769045129",
            "telephone_number": "325-223-6300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKS",
        "first_name": "BRADY",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-10",
        "last_updated": "2020-02-10",
        "certification_date": "2020-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "120585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Angelo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.