Kristen Nicole Brewer, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA4404 Issued in AR

Practice address

300 Kathy Drive
Russellville, AR 72802

Phone

(501) 253-2804

NPI assigned

Jan 13, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kristen Nicole Patterson Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• New Hope Therapy LLC

  • Multi-Specialty Clinic/Center
  • Hot Springs, AR
  • NPI 1245747039
  NPD

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

{
    "created_epoch": "1578873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679443200000",
    "number": "1114567773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 KATHY DRIVE",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "72802",
            "telephone_number": "501-253-2804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 KATHY DRIVE",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "72802",
            "telephone_number": "501-253-2804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREWER",
        "first_name": "KRISTEN",
        "middle_name": "NICOLE",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-13",
        "last_updated": "2023-03-22",
        "certification_date": "2023-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "AR",
            "license": "PTA4404",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "237780721",
            "state": "AR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "fusionwebclinic.com",
            "affiliation": "N",
            "endpointDescription": "Fusion",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4328 Central Ave Ste M",
            "city": "Hot Springs",
            "state": "AR",
            "country_code": "US",
            "postal_code": "719135907",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "PATTERSON",
            "middle_name": "NICOLE",
            "credential": "PTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Caitlyn J Brazil, OTD, OTR/L
• Abigail Breer
• Clifford G Breier, CRNA
• Candace Dawn Brewer, LAC
• Jenna Brewer, DPT
• Chantal Brice, LPC
• Loni Briley, AU.D.
• Jerrick Taylor Brixey, COTA
• Jonathan David Brixey, M.D.
• Khadejah Brockman

• Physical Therapy Assistant in Russellville, AR
• Providers in Russellville, AR by specialty
• Physical Therapy Assistant in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2023; 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.