Brentwood Physical Therapy Limited

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

BRENTWOOD PHYSICAL THERAPY LIMITED

Doing business as

Brentwood Center Of Health

Practice address

2558 S Brentwood Blvd
Saint Louis, MO 63144-2309

Phone

(314) 961-8940

Fax

(314) 961-8969

NPI assigned

Nov 23, 2005

Last updated

Feb 3, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Robert Shawn Tucker, PTNPI 1497905327

Title

President

Phone

(314) 961-8940

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Brentwood Center Of Health Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1336122266. Details of each certification follow.

• CCN 266569 Outpatient physical therapy / speech pathology · Active · Name & address match · Details

Outpatient physical therapy / speech pathology certification: CCN 266569

Legal name

BRENTWOOD PHYSICAL THERAPY, LIMITED PARTNERSHIP

Certification status

Active

Provider type (POS)

Outpatient physical therapy / speech pathology

Participating since

Sep 21, 1993

Last certification

Apr 25, 2023

Ownership / control type

Proprietary

Most recent change of ownership

Jan 1, 2002

Facility address

2558 S. Brentwood Blvd
Saint Louis, MO 63144

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Central Missouri Physical Therapy LLC

  dba Peak Sport and Spine

  • Physical Therapist
  • Columbia, MO
  • NPI 1558436592

  Member Of

  NPD member

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Robert Shawn Tucker, P.T.

  • Physical Therapist
  • Saint Louis, MO
  • NPI 1497905327
  NPD (past) Authorized official

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

{
    "created_epoch": "1132704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359849600000",
    "number": "1336122266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2558 S BRENTWOOD BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631442309",
            "telephone_number": "314-961-8940",
            "fax_number": "314-961-8969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2558 S BRENTWOOD BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631442309",
            "telephone_number": "314-961-8940",
            "fax_number": "314-961-8969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRENTWOOD PHYSICAL THERAPY LIMITED",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-23",
        "last_updated": "2013-02-03",
        "status": "A",
        "authorized_official_last_name": "TUCKER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "SHAWN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-961-8940",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "31348",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brentwood Center Of Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brentmoor Retirement Community
• Brentwood Family Chiropractic Center, LLC
• Brentwood Family Dental Center, LLC
• Brentwood Painstop LLC
• Brentwood Pediatrics PC
• Alexander Angelo Brescia, MD
• Carol Zarinelli Brescia, L.C.S.W.
• Madeleine Rose Bresnahan
• Cathleen F Brethauer, R.N.-C, W.H.N.P.
• Bethany F Brett, PA-C

• Physical Therapy Clinic/Center in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Physical Therapy Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.