Sherri Broekemeier, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

117112 Issued in MO

Practice address

404 E 3Rd St
Stover, MO 65078-0947

Phone

(573) 377-4521

NPI assigned

Nov 19, 2014

Last updated

Nov 19, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1416355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416355200000",
    "number": "1477950459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 CLUB VILLAGE DR",
            "address_2": "SUITE 103",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652034409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 E 3RD ST",
            "city": "STOVER",
            "state": "MO",
            "postal_code": "650780947",
            "telephone_number": "573-377-4521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROEKEMEIER",
        "first_name": "SHERRI",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-19",
        "last_updated": "2014-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MO",
            "license": "117112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bristol Care, Inc.
• Capital Region Medical Center (Capital Region Medical Clinic-Stover)
• Kayla Ann Davis, COTA
• Terrie Durbin
• Golden Age Nursing Home District (Golden Age Living Center)
• Kari Hollingsworth, MS CCC SLP

• Physical Therapy Assistant in Stover, MO
• Providers in Stover, MO by specialty
• Physical Therapy Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2014; 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.