Brandon Keith Fletcher, PT, DPT, ATC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2014031708 Issued in MO

Practice address

115 W Broadway Blvd
Ste 300
Sedalia, MO 65301-5708

Phone

(660) 827-2945

Fax

(660) 827-2961

NPI assigned

Aug 25, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Cwo Enterprises

  • Pediatric Occupational Therapist
  • Grain Valley, MO
  • NPI 1841890340
  NPD (past) Authorized official

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

{
    "created_epoch": "1314230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486598400000",
    "number": "1639459332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8823 PRODUCTION LN",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373636511",
            "telephone_number": "423-238-7217",
            "fax_number": "423-238-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 W BROADWAY BLVD",
            "address_2": "STE 300",
            "city": "SEDALIA",
            "state": "MO",
            "postal_code": "653015708",
            "telephone_number": "660-827-2945",
            "fax_number": "660-827-2961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLETCHER",
        "first_name": "BRANDON",
        "middle_name": "KEITH",
        "credential": "PT, DPT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-25",
        "last_updated": "2017-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MO",
            "license": "2011030388",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2014031708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Fiene, RPH
• Mary Allison Fischer, D.O.
• Barbara Carlene Fisher
• Wendy Sue Fisher
• Garrett Audrey Fizer, PROVISIONAL LBA
• Molly Foster, DMD
• Robert Stephen Foster, M.D.
• Four Seasons Living Center, LLC
• Four Seasons Living Center, LLC
• Four Seasons SNF Opco LLC

• Physical Therapist in Sedalia, MO
• Providers in Sedalia, MO by specialty
• Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2017; 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.