Active NPI
Robert Ray Brewer, PT, MOMT
- Physical Therapist
- Chewelah, WA
National Provider Identifier
1396838009
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT00003967
- Practice address
- N. 119 3Rd St. E.
Chewelah, WA 99109 - Phone
- (509) 935-4988
- Fax
- (509) 935-4985
- NPI assigned
- Oct 2, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT00003967 | WA | Primary |
Addresses
Primary practice location
N. 119 3Rd St. E.
Chewelah, WA 99109
Mailing address
P.O. Box 909
Chewelah, WA 99109
Phone (509) 935-4988
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7091564 | Medicaid | WA | |
| 0123911 | Other | WA | LABOR AND INDUSTRIES |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT00003967 | WA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1396838009",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 909",
"city": "CHEWELAH",
"state": "WA",
"postal_code": "99109",
"telephone_number": "509-935-4988",
"fax_number": "509-935-4985"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "N. 119 3RD ST. E.",
"city": "CHEWELAH",
"state": "WA",
"postal_code": "99109",
"telephone_number": "509-935-4988",
"fax_number": "509-935-4985"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BREWER",
"first_name": "ROBERT",
"middle_name": "RAY",
"credential": "PT, MOMT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "PT00003967",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7091564",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LABOR AND INDUSTRIES",
"identifier": "0123911",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chewelah, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.