Tracy Lynn Douthard, PT, DMIN

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2015002291 Issued in MO

Practice address

714 State Highway 248 Ste 503
Branson, MO 65616

Phone

(417) 230-1662

NPI assigned

Dec 17, 2014

Last updated

Jun 30, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Tracy Lynn Mosher Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Douthard Physical Therapy LLC

  • Physical Therapy Clinic/Center
  • Branson, MO
  • NPI 1730675885
  Authorized official Same address or phone
• Fully Known Chiropractic

  • Chiropractor
  • Branson, MO
  • NPI 1790308054
  NPD

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

{
    "created_epoch": "1418774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530316800000",
    "number": "1538567938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 HIGHPOINTS RDG",
            "city": "BRANSON",
            "state": "MO",
            "postal_code": "656167814",
            "telephone_number": "417-230-1662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 STATE HIGHWAY 248 STE 503",
            "city": "BRANSON",
            "state": "MO",
            "postal_code": "65616",
            "telephone_number": "417-230-1662"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2416 Savage Dr",
            "address_purpose": "LOCATION",
            "city": "Lapeer",
            "state": "MI",
            "postal_code": "484468073",
            "country_code": "US",
            "telephone_number": "810-793-4054",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "800 State Highway 248 Ste 503",
            "address_purpose": "LOCATION",
            "city": "Branson",
            "state": "MO",
            "postal_code": "656163721",
            "country_code": "US",
            "telephone_number": "417-230-1662",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOUTHARD",
        "first_name": "TRACY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "PT, DMIN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-17",
        "last_updated": "2018-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501011028",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2015002291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACY",
            "last_name": "MOSHER",
            "middle_name": "LYNN",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Keana R Dizon-Tuck, RN
• Dorlon Optical LLC (Pearle Vision)
• Shanna Dorlon
• Doulos Ministries, Inc. (Shelterwood)
• Douthard Physical Therapy LLC
• Dr Christian R D Willard,DDS,PC
• Dr Lukes Family Medicine LLC
• Dr Rebecca Pearson LLC
• Dr. Dale & Co. Inc
• Mittie M Dragosljvich, MD

• Physical Therapist in Branson, MO
• Providers in Branson, MO by specialty
• Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2018; 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.