Brooke Marie Leonard, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

001418 Issued in IA

Practice address

3375 Lake Ridge Dr
Dubuque, IA 52003-7864

Phone

(563) 207-8932

NPI assigned

May 13, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Brooke Backes Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Statera LLC

  • Primary Care Clinic/Center
  • Dubuque, IA
  • NPI 1689172751
  NPD (past)

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

{
    "created_epoch": "1557705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557705600000",
    "number": "1376109579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "963 HEATHER DR",
            "city": "PEOSTA",
            "state": "IA",
            "postal_code": "520689452",
            "telephone_number": "563-513-8819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3375 LAKE RIDGE DR",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520037864",
            "telephone_number": "563-207-8932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEONARD",
        "first_name": "BROOKE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-13",
        "last_updated": "2019-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IA",
            "license": "001418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BROOKE",
            "last_name": "BACKES",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Matthew David Leifker, MS, CADC
• Steven Matthew Leifker, D.D.S.
• Christopher J Leigh, M.D.
• Jennifer Leist, D.C.
• Randall William Lengeling, M.D.
• Leslie Kremer, DPT, LLC
• Leslie Kremer, DPT, LLC
• Mary Alice Letsche, RPH
• Lettman Chiropractic Rehab Care
• Gregory Dean Lettman, D.C.

• Physical Therapy Assistant in Dubuque, IA
• Providers in Dubuque, IA by specialty
• Physical Therapy Assistant in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2019; 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.