Jordan Brewer, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT27428 Issued in FL

Practice address

16201 Panama City Beach Pkwy
Suite a
Panama City Beach, FL 32413-5306

Phone

(850) 250-0826

Fax

(850) 250-0840

NPI assigned

Jun 13, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Axis Physiotherapy Institute, LLCGroup PAC ID 2860825353, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Axis Physiotherapy Institute, LLC

  • Physical Therapist
  • Fort Walton Beach, FL
  • NPI 1790328045
  Medicare reassignment Care Compare group NPD
• Premier Rehab Management, LLC

  • Physical Therapist
  • Navarre, FL
  • NPI 1821014390
  NPD (past)

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

{
    "created_epoch": "1402617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581552000000",
    "number": "1477967867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "339 RACETRACK RD NW",
            "address_2": "STE 20",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325471581",
            "telephone_number": "334-625-5795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16201 PANAMA CITY BEACH PKWY",
            "address_2": "SUITE A",
            "city": "PANAMA CITY BEACH",
            "state": "FL",
            "postal_code": "324135306",
            "telephone_number": "850-250-0826",
            "fax_number": "850-250-0840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREWER",
        "first_name": "JORDAN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-13",
        "last_updated": "2020-02-13",
        "certification_date": "2020-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT27428",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12734214",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA BLUE",
            "identifier": "Y0N0E",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Levee Bowen, RPH
• Tyler M Bowersox, DC
• Regina Ruth Bragiel, RN
• Christi Ann Brannon, MA, CCC-SLP
• Breakfast Point Pediatrics Inc
• Bridging the Gap Outpatient, LLC
• Bridging the Gap Recovery, LLC
• Lachristie Nicole Britton
• Krystal Marie Brown, LMT
• Leslie Brown

• Physical Therapist in Panama City Beach, FL
• Providers in Panama City Beach, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2020; 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.