Broadbent Rehab LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

BROADBENT REHAB LLC

Practice address

3550 E Delmar St
Springfield, MO 65809-1440

Phone

(417) 880-5002

NPI assigned

Apr 30, 2021

Organization subpart

No

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

Authorized official

Name

Mr. Tim W Broadbent, MS, PT

Title

Supervising Physical Therapist

Phone

(417) 880-5002

Specialties & licenses 1

Addresses

Other names 1

• BROADBENT REHAB LLC Doing business as

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Timothy Broadbent, MS, PT

  • Physical Therapist
  • Ozark, MO
  • NPI 1972778124

  MO, Physical Therapist

  Medicare reassignment NPD

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

{
    "created_epoch": "1619740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619740800000",
    "number": "1477136133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3550 E DELMAR ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658091440",
            "telephone_number": "417-880-5002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3550 E DELMAR ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658091440",
            "telephone_number": "417-880-5002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROADBENT REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-30",
        "last_updated": "2021-04-30",
        "certification_date": "2021-04-30",
        "status": "A",
        "authorized_official_last_name": "BROADBENT",
        "authorized_official_first_name": "TIM",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "SUPERVISING PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "417-880-5002",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MS, PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BROADBENT REHAB LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Linda L. Britt, LPC
• Shelby Britt, PA-C
• James Britton Jr., PHARM.D.
• Aaliyah Marie Brizendine
• Todd Brizendine, LPC
• Loren E Broaddus, M.D.
• Don L Brockman, MD
• Myron D. Brockman, M.D.
• Madison Mackenzie Broderick
• Amanda Christine Brodeur, MD

• All providers in Springfield, MO
• Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.