Active NPI
Bryn Hester
- Physical Therapist
- Poplar Bluff, MO
National Provider Identifier
1487209151
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2019030011
- Practice address
- 3381 Kanell Blvd
Poplar Bluff, MO 63901-3060 - Phone
- (573) 785-0761
- NPI assigned
- Aug 8, 2019
- 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 | 2019030011 | MO | Primary |
Addresses
Primary practice location
3381 Kanell Blvd
Poplar Bluff, MO 63901-3060
Mailing address
2596 Hickman Road Apt.1
Poplar Bluff, MO 63901
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 |
|---|---|---|---|
| 2019030011 | MO | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1565222400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565222400000",
"number": "1487209151",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2596 HICKMAN ROAD APT.1",
"city": "POPLAR BLUFF",
"state": "MO",
"postal_code": "63901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3381 KANELL BLVD",
"city": "POPLAR BLUFF",
"state": "MO",
"postal_code": "639013060",
"telephone_number": "573-785-0761"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HESTER",
"first_name": "BRYN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-08-08",
"last_updated": "2019-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MO",
"license": "2019030011",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Poplar Bluff, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.