Individual provider Active NPI

Braeden Micah Cooper, PT, DPT

  • Physical Therapist
  • Wichita, KS
National Provider Identifier
1659905107
Registry record updated May 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11-07427 Issued in KS
Practice address
10100 E Shannon Woods Cir Ste 2
Wichita, KS 67226-4105
Phone
(316) 681-0824
NPI assigned
Feb 24, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2025

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 11-07427 KS Primary

Addresses

Primary practice location

10100 E Shannon Woods Cir Ste 2
Wichita, KS 67226-4105

Mailing address

10100 E Shannon Woods Cir Ste 2
Wichita, KS 67226-4105
Phone (316) 681-0824

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240321002431 KS Practitioner - Physical Therapist in Private Practice 0042657397 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

9828 E Shannon Woods Cir
Suite 200
Wichita, KS 67226-4100
Phone (316) 274-3540

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11-07427KSMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Via Christi Rehabilitation Hospital, Inc. Physical Therapist CurrentSince Feb 11, 2024 Accepting new patients
Ascension Via Christi Rehabilitation Hospital, Inc. Physical Therapist CurrentSince Feb 11, 2024 Accepting new patients
Via Christi Rehabilitation Hospital, Inc Physical Therapist Past Accepting new patients

Locations

10100 E Shannon Woods Cir
Wichita, KS 67226
Phone (316) 858-1900

10100 E Shannon Woods Cir
Ste 2
Wichita, KS 67226
Phone (316) 681-0824

1151 N Rock Rd
Wichita, KS 67206
Phone (316) 634-3400

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1582502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748304000000",
    "number": "1659905107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10100 E SHANNON WOODS CIR STE 2",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672264105",
            "telephone_number": "316-681-0824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10100 E SHANNON WOODS CIR STE 2",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672264105",
            "telephone_number": "316-681-0824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "BRAEDEN",
        "middle_name": "MICAH",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-24",
        "last_updated": "2025-05-27",
        "certification_date": "2025-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KS",
            "license": "11-07427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.