Active NPI
Michelle Lynn Brown, P.T.
- Physical Therapist
- Des Moines, IA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 02961
- Practice address
- 3200 Grand Ave
Des Moines, IA 50312-4104 - Phone
- (515) 271-1717
- Fax
- (515) 271-7185
- NPI assigned
- Jan 22, 2008
- Sex
- Female
- 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 | 02961 | IA | Primary |
Addresses
Primary practice location
3200 Grand Ave
Des Moines, IA 50312-4104
Mailing address
3200 Grand Ave
Des Moines, IA 50312-4104
Phone (515) 271-1717
Other names 1
- Michelle Lynn Bogan
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120918000831 | IA | Practitioner - Physical Therapist in Private Practice | 6709902729 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Des Moines University Osteopathic Medical Center
Practice addresses (Care Compare)
3200 Grand Ave
FL 5
Des Moines, IA 50312-4104
Phone (515) 271-1707
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 02961 | IA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Des Moines University Osteopathic Medical Center | Physical Therapist | Current | Accepting new patients |
| Des Moines University Osteopathic Medical Center | Physical Therapist | Current | Accepting new patients |
Locations
3200 Grand Ave
Des Moines, IA 50312
Phone (515) 271-1700
1555 Hull Ave
Des Moines, IA 50316
Phone (515) 262-5639
3200 Grand Ave
Fl 5
Des Moines, IA 50312
Phone (515) 271-1707
6500 Grand Ave
Ste 110
West Des Moines, IA 50266
Phone (515) 271-1710
Interoperability endpoints
- michelle.brown.1@11667.direct.athenahealth.com
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 and National Provider Directory roles.
-
- Family Medicine Physician
- Des Moines, IA
- NPI 1164475760
IA, Physical Therapist
-
- Durable Medical Equipment & Medical Supplies
- Des Moines, IA
- NPI 1043380801
Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1200960000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1582070400000",
"number": "1497932453",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3200 GRAND AVE",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503124104",
"telephone_number": "515-271-1717",
"fax_number": "515-271-7185"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3200 GRAND AVE",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503124104",
"telephone_number": "515-271-1717",
"fax_number": "515-271-7185"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROWN",
"first_name": "MICHELLE",
"middle_name": "LYNN",
"name_prefix": "Mrs.",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-01-22",
"last_updated": "2020-02-19",
"certification_date": "2020-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IA",
"license": "02961",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MICHELLE",
"last_name": "BOGAN",
"middle_name": "LYNN",
"credential": "P.T.",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Des Moines, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 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.