Blaine Raymond Brooks, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

LPT-9088 Issued in AZ

Practice address

2510 E Hunt Hwy Ste 26-27
San Tan Valley, AZ 85143-5206

Phone

(480) 618-0480

Fax

(480) 618-0481

NPI assigned

Sep 14, 2010

Last updated

Dec 13, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Experience Physical Therapy LLCGroup PAC ID 1557781903, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Experience Physical Therapy LLC

  • Physical Therapist
  • San Tan Valley, AZ
  • NPI 1447877105
  Medicare reassignment Care Compare group NPD
• Performance Physical Therapy, LLC

  • Physical Therapist
  • Tempe, AZ
  • NPI 1962511949
  NPD (past)

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

{
    "created_epoch": "1284422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734048000000",
    "number": "1366750101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2510 E HUNT HWY STE 27",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851435208",
            "telephone_number": "480-618-0480",
            "fax_number": "480-618-0481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 E HUNT HWY STE 26-27",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851435206",
            "telephone_number": "480-618-0480",
            "fax_number": "480-618-0481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "BLAINE",
        "middle_name": "RAYMOND",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-14",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "LPT-9088",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "9088",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brooke Brennan
• Keyla Machell Briese, PT, DPT
• Bright Bites Therapy PLLC
• Brighter Days Alliance LLC
• Debra I Bro
• Brothers and Keepers Corporation
• Brower Dental PLLC (Copper Creek Dental)
• Jennifer Marie Brown, NP
• Kristina Brown, COTA/L
• Palaire Brown, PHARMD

• Physical Therapist in San Tan Valley, AZ
• Providers in San Tan Valley, AZ by specialty
• Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2024; 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.