Brooke Mitchell Physical Therapy, Inc.

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

BROOKE MITCHELL PHYSICAL THERAPY, INC.

Doing business as

Maven Physical Therapy and Performance

Practice address

1243 7TH St Ste C
Santa Monica, CA 90401-1656

Phone

(424) 272-9767

NPI assigned

Jul 21, 2021

Organization subpart

No

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

Authorized official

Name

Brooke Mitchell, DPTNPI 1851443923

Title

Ceo

Phone

(424) 272-9767

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Maven Physical Therapy and Performance Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brooke Siebel Mitchell, D.P.T.

  • Physical Therapist
  • Santa Monica, CA
  • NPI 1851443923
  NPD Authorized official

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

{
    "created_epoch": "1626825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626825600000",
    "number": "1144893710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1057 CORSICA DR",
            "city": "PACIFIC PALISADES",
            "state": "CA",
            "postal_code": "902724013",
            "telephone_number": "310-490-7817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1243 7TH ST STE C",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904011656",
            "telephone_number": "424-272-9767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKE MITCHELL PHYSICAL THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-21",
        "last_updated": "2021-07-21",
        "certification_date": "2021-07-21",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "BROOKE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "424-272-9767",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSONAL NPI",
            "identifier": "1851443923",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maven Physical Therapy and Performance",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bruce Robertson Brodie, PH.D.
• Nkechinyere Brodie, CNM, APRN
• Sarah Auld Brokaw, LCSW
• Susan J Bronstein, REGISTERED NURSE
• Robert M Brook, PH.D.
• Brookfield Group
• Daniel C Brooks, M.D.
• Serena Brooks
• Andra Brosh
• Stanley Allen Brosman, MD

• Physical Therapy Clinic/Center in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Physical Therapy Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2021; 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.