Brian T. Boerner, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1103448 Issued in KS

Practice address

11504 W 135TH St
Overland Park, KS 66221-2892

Phone

(913) 681-9909

Fax

(913) 681-9906

NPI assigned

May 21, 2007

Last updated

Jul 10, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in KS

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northland Physical Therapy and Rehab Services IncGroup PAC ID 1850370453, 120 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Northland Physical Therapy & Rehab Services, Inc

  • Physical Therapist
  • N Kansas City, MO
  • NPI 1740273218

  KS

  Medicare reassignment Care Compare group
• Dickson Diveley Midwest Orthopaedic Clinic LLC

  • Orthopaedic Surgery Physician
  • Leawood, KS
  • NPI 1669421509
  NPD
• Dickson Diveley Midwest Orthopaedic Clinic LLC

  dba Kansas City Orthopedic Alliance

  • Durable Medical Equipment & Medical Supplies
  • Lenexa, KS
  • NPI 1730946302
  NPD

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404950400000",
    "number": "1164630265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19631 W 97TH ST",
            "city": "LENEXA",
            "state": "KS",
            "postal_code": "662203349",
            "telephone_number": "913-522-2875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11504 W 135TH ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662212892",
            "telephone_number": "913-681-9909",
            "fax_number": "913-681-9906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOERNER",
        "first_name": "BRIAN",
        "middle_name": "T.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-21",
        "last_updated": "2014-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KS",
            "license": "1103448",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2004017077",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FREEDOM NETWORK",
            "identifier": "29971",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "5712220",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "29971",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED HEALTH PROFESSIONALS",
            "identifier": "29971",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7907868",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "29971025",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Body Basics Chiropractic LLC
• Body Guitar, LLC (Body Guitar Clinic)
• Body Logic LLC
• Body Synergy Wellness Center
• Dakota Jane Boehler
• Katie Bogart, RBT
• Thomas Carl Boge, PH.D., R.PH.
• Jennifer L Boggess, DC
• Jessica Bohlke, DC
• Tyler Ray Bohlke, DC

• Physical Therapist in Overland Park, KS
• Providers in Overland Park, KS by specialty
• Physical Therapist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2014; 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.