Individual provider Active NPI

Brian Fauntleroy, PT

  • Physical Therapist
  • Missoula, MT
National Provider Identifier
1124877170
Registry record updated Jan 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
4915 Lower Miller Creek Rd
Missoula, MT 59803-9659
Phone
(406) 251-2323
NPI assigned
May 14, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X MT Primary

Addresses

Primary practice location

4915 Lower Miller Creek Rd
Missoula, MT 59803-9659

Mailing address

5000 Blue Mountain Rd
Missoula, MT 59804-9213
Phone (406) 251-2323

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240829002912 MT Practitioner - Physical Therapist in Private Practice 2163961483 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dodge Works PT, Inc Dba Alpine Physical TherapyGroup PAC ID 0749285179, 32 clinicians

Practice addresses (Care Compare)

4915 Lower Miller Creek Rd
Missoula, MT 59803-9647
Phone (406) 251-2323

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dodge Works PT, Inc Dba Alpine Physical Therapy Physical Therapist CurrentSince Jun 18, 2025 Accepting new patients
Plains Physical Therapy PC CurrentSince Jun 2, 2024 Accepting new patients
Dodge Works PT, Inc Dba Alpine Physical Therapy Physical Therapist CurrentSince Jun 18, 2025 Accepting new patients

Locations

5000 Blue Mountain Rd
Missoula, MT 59804
Phone (406) 251-2323

4915 Lower Miller Creek Rd
Missoula, MT 59803
Phone (406) 251-2323

Organizations & group practices 3

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": "1715644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767744000000",
    "number": "1124877170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 BLUE MOUNTAIN RD",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598049213",
            "telephone_number": "406-251-2323",
            "fax_number": "406-251-2999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4915 LOWER MILLER CREEK RD",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598039659",
            "telephone_number": "406-251-2323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAUNTLEROY",
        "first_name": "BRIAN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-14",
        "last_updated": "2026-01-07",
        "certification_date": "2026-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2026; 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.