Individual provider Active NPI

Brett Huether, DPT, PT

  • Physical Therapist
  • St Augustine, FL
National Provider Identifier
1205200276
Registry record updated Aug 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
29721 Issued in FL
Practice address
107 Menendez Rd
St Augustine, FL 32080-5327
Phone
(970) 471-6480
NPI assigned
Nov 13, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2020

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 29721 FL Primary

Addresses

Primary practice location

107 Menendez Rd
St Augustine, FL 32080-5327

Mailing address

107 Menendez Rd
St Augustine, FL 32080-5327
Phone (970) 471-6480

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200827002162 FL Practitioner - Physical Therapist in Private Practice 8426475021 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
29721FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Brett Huether LLC Physical Therapist CurrentSince Sep 1, 2020 Accepting new patients

Organizations & group practices 1

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": "1447372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596499200000",
    "number": "1205200276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 MENENDEZ RD",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320805327",
            "telephone_number": "970-471-6480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 MENENDEZ RD",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320805327",
            "telephone_number": "970-471-6480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUETHER",
        "first_name": "BRETT",
        "credential": "DPT, PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-11-13",
        "last_updated": "2020-08-04",
        "certification_date": "2020-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "29721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.