Individual provider Active NPI

Ernestine C Brashear, PT

  • Physical Therapist
  • Berea, KY
National Provider Identifier
1639115363
Registry record updated Sep 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
000834 Issued in KY
Practice address
193 Glades Rd
Berea, KY 40403-1369
Phone
(859) 986-1055
Fax
(859) 986-1002
NPI assigned
Jun 21, 2006
Last updated
Sep 20, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 000834 KY Primary

Addresses

Primary practice location

193 Glades Rd
Berea, KY 40403-1369

Mailing address

3425 Executive Pkwy
Suite 128
Toledo, OH 43606-1333
Phone (418) 537-0764

Other identifiers 1

IdentifierTypeStateIssuer
87008348MedicaidKY

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
H2 Rehabilitation Services of Kentucky, LLC Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284940800000",
    "number": "1639115363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3425 EXECUTIVE PKWY",
            "address_2": "SUITE 128",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436061333",
            "telephone_number": "418-537-0764",
            "fax_number": "419-537-0948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "193 GLADES RD",
            "city": "BEREA",
            "state": "KY",
            "postal_code": "404031369",
            "telephone_number": "859-986-1055",
            "fax_number": "859-986-1002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRASHEAR",
        "first_name": "ERNESTINE",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-21",
        "last_updated": "2010-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "000834",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "87008348",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berea, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2010; 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.