Thomas John Brewer, MA

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

528621 Issued in MN

Practice address

2495 Maplewood Dr
Suite 313
Maplewood, MN 55109

Phone

(651) 770-8884

NPI assigned

Mar 14, 2024

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

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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 and National Provider Directory roles.

• Functional Integrated Therapy, LTD

  dba Functional Kids Clinic

  • Rehabilitation Clinic/Center
  • Maplewood, MN
  • NPI 1477640613
  Medicare reassignment NPD

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

{
    "created_epoch": "1710374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710374400000",
    "number": "1568221414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12555 PENNOCK AVE APT 320",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551246073",
            "telephone_number": "218-820-1475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2495 MAPLEWOOD DR",
            "address_2": "SUITE 313",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "55109",
            "telephone_number": "651-770-8884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREWER",
        "first_name": "THOMAS",
        "middle_name": "JOHN",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-14",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "528621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Braski
• Joseph P Braun, MD
• Kristin Mary Breimhurst Miller, P.T.
• Andrea Brekke
• Stephen Brennan
• Madison Therese Brickner, MD
• Bright Hope Care LLC
• Asryen Brown
• Holly Marie Brown, COTA/L
• Mary K Brown, MD

• Speech-Language Pathologist in Maplewood, MN
• Providers in Maplewood, MN by specialty
• Speech-Language Pathologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.