Individual provider Active NPI

Brennan David McNitt, DPT

  • Physical Therapist
  • Council Bluffs, IA
National Provider Identifier
1437641099
Registry record updated May 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
091308 Issued in IA
Practice address
928 Valley View Dr Ste 7
Council Bluffs, IA 51503-5288
Phone
(800) 930-8803
NPI assigned
May 30, 2018
Last updated
May 30, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2018

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 091308 IA Primary

Addresses

Primary practice location

928 Valley View Dr Ste 7
Council Bluffs, IA 51503-5288

Mailing address

928 Valley View Dr Ste 7
Council Bluffs, IA 51503-5288

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211208003438 NE Practitioner - Physical Therapist in Private Practice 0547514044 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Iowa, RJ & L Carver College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Executive Health Solutions LLCGroup PAC ID 7113250929, 3 clinicians

Practice addresses (Care Compare)

21015 Cumberland Dr
Suite 201
Elkhorn, NE 68022-4110
Phone (402) 320-8770

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
091308IAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Executive Health Solutions, LLC Physical Therapist CurrentSince Nov 8, 2021 Accepting new patients
Flex Physical Therapy LLC PastSince Jan 1, 2018 Accepting new patients

Locations

21015 Cumberland Dr
Ste 201
Elkhorn, NE 68022
Phone (402) 320-8770

1016 S 74th Plz
Omaha, NE 68114
Phone (402) 939-8026

4951 Center St
Ste Ll
Omaha, NE 68106
Phone (402) 305-4344

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1527638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527638400000",
    "number": "1437641099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "928 VALLEY VIEW DR STE 7",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515035288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "928 VALLEY VIEW DR STE 7",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515035288",
            "telephone_number": "800-930-8803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNITT",
        "first_name": "BRENNAN",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-30",
        "last_updated": "2018-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "091308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Council Bluffs, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2018; 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.