Ira Jason Brown, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2012016550 Issued in MO

Practice address

850 E San Martin St
Bolivar, MO 65613-2897

Phone

(417) 777-2888

NPI assigned

Jun 18, 2012

Last updated

Jun 18, 2012By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Bolivar Physical Therapy Center, LLC

  • Physical Therapist
  • Bolivar, MO
  • NPI 1366454191
  NPD (past)
• Oa Centers of Kansas City, LLC

  dba Freedom Healthcare

  • Physical Medicine & Rehabilitation Physician
  • Independence, MO
  • NPI 1346511268

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1339977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339977600000",
    "number": "1619230489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4077 S 97TH RD",
            "city": "BOLIVAR",
            "state": "MO",
            "postal_code": "656138512",
            "telephone_number": "417-777-5865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 E SAN MARTIN ST",
            "city": "BOLIVAR",
            "state": "MO",
            "postal_code": "656132897",
            "telephone_number": "417-777-2888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "IRA",
        "middle_name": "JASON",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-18",
        "last_updated": "2012-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2012016550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian G. Hackleman, D.C., L.L.C.
• Rebecca L. Briggs, MS, CCC-SLP
• Carmen Broadbent, PHARMD
• Jason Brooks, CRNA
• Garry J Brown, DO
• Courtney Marie Brummel, MSN, FNP-C
• Susan Kay Buchen, SLP, CCC
• Samuel Christian Buesking, PHARMD
• Mark J Bult, M.D.
• Jennifer A Bushre, APRN, NP

• Physical Therapist in Bolivar, MO
• Providers in Bolivar, 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 18, 2012; 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.