Individual provider Active NPI

Barry D Brown, PT

  • Physical Therapist
  • Pueblo, CO
National Provider Identifier
1366491615
Registry record updated Nov 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4230 Issued in CO
Practice address
21 Montebello Rd
Pueblo, CO 81001-1236
Phone
(719) 546-0037
Fax
(719) 546-0039
NPI assigned
May 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2022

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 4230 CO Primary

Addresses

Primary practice location

21 Montebello Rd
Pueblo, CO 81001-1236

Mailing address

21 Montebello Rd
Pueblo, CO 81001-1236
Phone (719) 546-0037

Other identifiers 1

IdentifierTypeStateIssuer
36781878MedicaidCO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110629000697 CO Practitioner - Physical Therapist in Private Practice 3375430457 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Oklahoma College of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Institute for Total RehabilitationGroup PAC ID 1850288929, 2 clinicians

Practice addresses (Care Compare)

21 Montebello Rd
Pueblo, CO 81001-1236
Phone (719) 546-0037

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4230COMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Institute for Total Rehabilitation Physical Therapist CurrentSince Sep 16, 2010 Accepting new patients
Institute for Total Rehabilitation CurrentSince Oct 16, 2022 Accepting new patients

Locations

2131 Jerry Murphy Rd
Pueblo, CO 81001
Phone (719) 546-0037

21 Montebello Rd
Pueblo, CO 81001
Phone (719) 546-0037

Organizations & group practices 2

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": "1146873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668124800000",
    "number": "1366491615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 MONTEBELLO RD",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810011236",
            "telephone_number": "719-546-0037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 MONTEBELLO RD",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810011236",
            "telephone_number": "719-546-0037",
            "fax_number": "719-546-0039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "BARRY",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-06",
        "last_updated": "2022-11-11",
        "certification_date": "2022-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "4230",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36781878",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2022; 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.