Brendan Alexander Black, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2021023467 Issued in MO

Practice address

1321 SW Market St
Lees Summit, MO 64081-2904

Phone

(816) 607-7180

Fax

(816) 607-7181

NPI assigned

Apr 28, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hill Pro-Motion Physical Therapy, LLCGroup PAC ID 1153582416, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Hill Pro-Motion Physical Therapy, LLC

  • Physical Therapist
  • Lees Summit, MO
  • NPI 1538431333
  Medicare reassignment Care Compare group NPD
• Serc Rehabilitation Partners, LLC

  • Physical Therapist
  • Belton, MO
  • NPI 1760745244
  Medicare reassignment NPD
• Serc Rebabilitation Partners, LLC

  • Physical Therapist
  • Overland Park, KS
  • NPI 1598190209
  NPD

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

{
    "created_epoch": "1619568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712275200000",
    "number": "1104409143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1321 SW MARKET ST",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640812904",
            "telephone_number": "816-607-7180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1321 SW MARKET ST",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640812904",
            "telephone_number": "816-607-7180",
            "fax_number": "816-607-7181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "BRENDAN",
        "middle_name": "ALEXANDER",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-28",
        "last_updated": "2024-04-05",
        "certification_date": "2024-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2021023467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bella Michelle Birdashaw, ARNP
• Vasiliy Birdsong
• Hannah Loren Bisges, MSW, LCSW
• Francine J Bishop, OTR
• Colton Michael Bitely, MD
• Xenia Zeldin Black, MSW, LCSW
• Mykaila Blackwell
• Flora Bland-Washington, LMSW
• Meghan Blay, DO
• Cynthia Sue Blood

• Physical Therapist in Lees Summit, MO
• Providers in Lees Summit, MO by specialty
• Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.