Breland Basler, DPT
Individual provider Active NPI Physical Therapist · Arnold, MO
NPI 1124542915 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1124542915
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 2017026590 (MO)
- Practice address
- 160 Richardson Xing
Arnold, MO 63010-6023 - Phone
- (636) 467-2730
- NPI assigned
- Aug 2, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20171102000551 | MO | Practitioner - Physical Therapist in Private Practice | 5496011710 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Arnold Physical Therapy & Sports Medicine LLC | Current |
Accepting new patients | |
| Arnold Physical Therapy & Sports Medicine LLC | Current |
Accepting new patients | |
| Physical Therapy Spine & Sports Medicine LLC | Past | Accepting new patients | |
| Physical Therapy Spine & Sports Medicine LLC | Past | Accepting new patients |
Locations
160 Richardson Xing
Arnold, MO 63010
Phone (636) 467-2730
9594 Manchester Rd
Saint Louis, MO 63119
Phone (314) 274-6314
2046 Queensbrooke Blvd
Ste 101
Saint Peters, MO 63376
Phone (636) 875-7085
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2017026590 | MO | Yes |
Addresses
Primary practice location
160 Richardson Xing
Arnold, MO 63010-6023
Mailing address
160 Richardson Xing
Arnold, MO 63010-6023
Phone (636) 467-2730
Other providers in Arnold, MO
- Stephanie A Bardgett
- Jaya Barina
- Sara Elizabeth Barker
- Joseph Barnard
- Kenneth A Barrett
- Clarice Basler
- Michele Katlyn Basler
- Caleb Aaron Bass
- Adam J Battaglia
- Erica Bauer
All providers in Arnold, MO · Physical Therapist in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.