Active NPI
Kelsey Breann Brasher, PT, DPT
- Pediatric Physical Therapist
- Huntsville, TX
National Provider Identifier
1619694163
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- CP015597T
- Practice address
- 100 Medical Center Pkwy Ste 100
Huntsville, TX 77340-4959 - Phone
- (936) 293-8800
- Fax
- (936) 715-3721
- NPI assigned
- Oct 25, 2022
- 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 |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | CP015597T | TX | Primary |
Addresses
Primary practice location
100 Medical Center Pkwy Ste 100
Huntsville, TX 77340-4959
Mailing address
105 Deer TRL
West Monroe, LA 71291-9459
Phone (318) 376-7531
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CP015597T | TX | MD | Pediatric Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1666656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666656000000",
"number": "1619694163",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 DEER TRL",
"city": "WEST MONROE",
"state": "LA",
"postal_code": "712919459",
"telephone_number": "318-376-7531"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 MEDICAL CENTER PKWY STE 100",
"city": "HUNTSVILLE",
"state": "TX",
"postal_code": "773404959",
"telephone_number": "936-293-8800",
"fax_number": "936-715-3721"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRASHER",
"first_name": "KELSEY",
"middle_name": "BREANN",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-10-25",
"last_updated": "2022-10-25",
"certification_date": "2022-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "TX",
"license": "CP015597T",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Huntsville, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.