Brent Hull, PT DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501018346 Issued in MI

Practice address

4177 Village Park Dr
Traverse City, MI 49685-7237

Phone

(231) 421-5805

Fax

(231) 421-8447

NPI assigned

Aug 30, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Elite Physical Therapy and Sports PerformanceGroup PAC ID 0042484560, 4 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.

• Elite Physical Therapy and Sports Performance

  • Physical Therapy Clinic/Center
  • Traverse City, MI
  • NPI 1427343383

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Functional Dimensions LLC

  • Orthopedic Physical Therapist
  • Traverse City, MI
  • NPI 1780076232

  Single Specialty

  NPD

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

{
    "created_epoch": "1504051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695081600000",
    "number": "1609394659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4177 VILLAGE PARK DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496857237",
            "telephone_number": "231-421-5805",
            "fax_number": "231-421-5308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4177 VILLAGE PARK DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496857237",
            "telephone_number": "231-421-5805",
            "fax_number": "231-421-8447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HULL",
        "first_name": "BRENT",
        "name_prefix": "Dr.",
        "credential": "PT DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-08-30",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501018346",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER",
            "identifier": "1750661542",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Victor Hughes, DNP
• Jason Alexander Hughey
• James Frederick Hulderman, DDS
• Alexandra Hull, DPT, ATC
• Autumn Danielle Hull, P.T.
• Hullman Family Chiropractic, PLC
• Jason Hullman, D.C.
• Jenifer Hullman, D.C.
• Jodi Marie Hummel, OD
• Abby Humphrey, DIPL.AC.

• Physical Therapist in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2023; 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.