Brian Conrad Fassold, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1104666 Issued in KS

Practice address

7211 W 110TH St
Overland Park, KS 66210-2339

Phone

(913) 451-7373

Fax

(913) 451-7375

NPI assigned

May 8, 2013

Last updated

Dec 8, 2021By the provider in NPPES

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

Enrolled in KS

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Mid America Balance Institute Inc

  • Other Specialist/Technologist
  • Overland Park, KS
  • NPI 1346412376

  MO, Physical Therapist

  Medicare reassignment NPD

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

{
    "created_epoch": "1367971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638921600000",
    "number": "1669817359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424",
            "telephone_number": "423-238-7217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7211 W 110TH ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662102339",
            "telephone_number": "913-451-7373",
            "fax_number": "913-451-7375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FASSOLD",
        "first_name": "BRIAN",
        "middle_name": "CONRAD",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-08",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KS",
            "license": "1104666",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2020010998",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaitlin L Farmerie
• Benjamin Luke Farrell, PT, DPT
• Daniel C Farrell, MD
• Kari C Farris, DO
• Zachary D. Fasig
• Aaron Fast, PT, DPT
• Sara Fattaey-Gray, LSCSW
• Jennifer Faus
• Mychaela Fawson
• Jessie Nichole Fazel, APRN

• Physical Therapist in Overland Park, KS
• Providers in Overland Park, KS by specialty
• Physical Therapist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.