Individual provider Active NPI

Stephen Richard Brown, PT,SCS,ATC

  • Physical Therapist
  • Saline, MI
National Provider Identifier
1265461875
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501006126 Issued in MI
Practice address
505 E Michigan Ave
Saline, MI 48176-1588
Phone
(734) 944-1005
Fax
(734) 944-1303
NPI assigned
Jul 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X
Sports Physical Therapist 2251S0007X L717912 MI
Physical Therapist 225100000X 5501006126 MI Primary

Addresses

Primary practice location

505 E Michigan Ave
Saline, MI 48176-1588

Mailing address

505 E Michigan Ave
Saline, MI 48176-1588
Phone (734) 944-1005

Other practice location 1

2810 Baker Rd
101
Dexter, MI 48130-1114
Phone (734) 424-9710

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501006126MIMDPhysical Therapist
L717912MIMDSports Physical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1265461875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 E MICHIGAN AVE",
            "city": "SALINE",
            "state": "MI",
            "postal_code": "481761588",
            "telephone_number": "734-944-1005",
            "fax_number": "734-944-1303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 E MICHIGAN AVE",
            "city": "SALINE",
            "state": "MI",
            "postal_code": "481761588",
            "telephone_number": "734-944-1005",
            "fax_number": "734-944-1303"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2810 Baker Rd",
            "address_2": "101",
            "address_purpose": "LOCATION",
            "city": "Dexter",
            "state": "MI",
            "postal_code": "481301114",
            "country_code": "US",
            "telephone_number": "734-424-9710",
            "fax_number": "734-424-9711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "STEPHEN",
        "middle_name": "RICHARD",
        "credential": "PT,SCS,ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "MI",
            "license": "L717912",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501006126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saline, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.