Brookly Jean Becke Thompson, DPT

Key facts

NPI

1306813670

Entity type

Individual (NPI type 1)

Primary specialty

Geriatric Physical Therapist 2251G0304X

License

070013159 (IL)

Practice address

167 Aberdeen
Paducah, KY 42001-6187

Phone

(815) 238-7218

NPI assigned

Mar 4, 2006

Sex

Female

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

Yes

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 19, 2021.

{
    "created_epoch": "1141430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613692800000",
    "number": "1306813670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "167 ABERDEEN",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420016187",
            "telephone_number": "815-238-7218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "167 ABERDEEN",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420016187",
            "telephone_number": "815-238-7218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECKE THOMPSON",
        "first_name": "BROOKLY",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-04",
        "last_updated": "2021-02-19",
        "certification_date": "2021-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "9949-024",
            "primary": false
        },
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "IL",
            "license": "070013159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Paducah, KY · Geriatric Physical Therapist in Kentucky