Individual provider Active NPI

Melissa Maidlow Brown, MPT, DPT

  • Physical Therapist
  • Kalamazoo, MI
National Provider Identifier
1083944763
Registry record updated Apr 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501010759 Issued in MI
Practice address
4030 Bronson Blvd
Kalamazoo, MI 49008-3134
Phone
(269) 464-0044
Fax
(844) 906-2440
NPI assigned
Jan 2, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X L1391211 MI
Physical Therapist 225100000X 5501010759 MI Primary

Addresses

Primary practice location

4030 Bronson Blvd
Kalamazoo, MI 49008-3134

Mailing address

4030 Bronson Blvd
Kalamazoo, MI 49008-3134
Phone (269) 464-0044

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL mmbrown@telefocuspt.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210423000714 MI Practitioner - Physical Therapist in Private Practice 1254749617 Practice locations: Kalamazoo, MI

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
L1391211MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Telefocus Physical Therapy, LLC Physical Therapist CurrentSince Apr 20, 2021 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1262390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618272000000",
    "number": "1083944763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4030 BRONSON BLVD",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490083134",
            "telephone_number": "269-464-0044",
            "fax_number": "844-906-2440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4030 BRONSON BLVD",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490083134",
            "telephone_number": "269-464-0044",
            "fax_number": "844-906-2440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "MELISSA",
        "middle_name": "MAIDLOW",
        "name_prefix": "Dr.",
        "credential": "MPT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-02",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "L1391211",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501010759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "mmbrown@telefocuspt.com",
            "affiliation": "N",
            "endpointDescription": "business email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4030 Bronson Blvd",
            "city": "Kalamazoo",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490083134",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2021; 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.