Brian Charles Prax, MA PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT-693 Issued in WY

Practice address

185 Powderhorn LN
Jackson, WY 83001-8426

Phone

(307) 200-1332

Fax

(307) 203-2255

NPI assigned

Oct 24, 2006

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)

Enrolled

Credentials

Master of Arts

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.

• Four Pines Physical Therapy Limited Partnership

  • Physical Therapist
  • Jackson, WY
  • NPI 1578373890
  NPD (past)
• Four Pines Physical Therapy PC

  • Physical Therapist
  • Jackson, WY
  • NPI 1013090539
  NPD (past)
• Jackson Hole Physical Therapy, PC

  • Orthopedic Physical Therapist
  • Wilson, WY
  • NPI 1952484511
  NPD (past)

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470614400000",
    "number": "1659454205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3185",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830013185",
            "telephone_number": "307-200-1332",
            "fax_number": "307-203-2255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 POWDERHORN LN",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830018426",
            "telephone_number": "307-200-1332",
            "fax_number": "307-203-2255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRAX",
        "first_name": "BRIAN",
        "middle_name": "CHARLES",
        "name_prefix": "Mr.",
        "credential": "MA PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2016-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WY",
            "license": "PT-693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark B Pommer, ED.M
• Kristin Poole
• P George Poore, MD
• Gary Post, MSW
• Lisa Marie Potzernitz
• Madison Prescott, RBT
• Natalie Prescott, MS, PPC
• Rosanne Prince, AU.D., CCC/A
• Jason D Provus, MD
• Ivy Pruss

• Physical Therapist in Jackson, WY
• Providers in Jackson, WY by specialty
• Physical Therapist in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2016; 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.