Scott Bradley Fieser, P.T., CSCS
Individual provider Active NPI Physical Therapist · Newton, KS
NPI 1093852907 · NPPES record last updated May 1, 2008
Key facts
- NPI
- 1093852907
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 11-03446 (KS)
- Practice address
- 2311 S Kansas Rd
Newton, KS 67114-9032 - Phone
- (316) 283-7187
- Fax
- (316) 283-7189
- NPI assigned
- Jan 31, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Premier Physical Therapy, PA
Practice addresses (Care Compare)
1220 W 21St St N
Suite a
Valley Center, KS 67205-1770
Phone (316) 613-3068
7340 W 21St St N
Suite 100
Wichita, KS 67205-1770
Phone (316) 613-3068
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070529000449 | KS | Practitioner - Physical Therapist in Private Practice | 8527165455 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03446 | KS | MD | Marriage & Family Therapist |
| 11-03446 | KS | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advanced Physical Therapy PA | Physical Therapist | Past | Accepting new patients |
| Advanced PT of Newton, LLC | Physical Therapist | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 11-03446 | KS | Yes |
Addresses
Primary practice location
2311 S Kansas Rd
Newton, KS 67114-9032
Mailing address
200 W Douglas Ave
Ste 1040
Wichita, KS 67202-3013
Phone (316) 263-0003
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200269680B | Medicaid | KS |
Other providers in Newton, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 1, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.