Bryce A Huddleston

Individual provider Active NPI Physical Therapist · Branson West, MO

NPI 1669852240 · NPPES record last updated Jun 9, 2015

Key facts

NPI
1669852240
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
2015017509 (MO)
Practice address
16282 State Highway 13 Ste F
Branson West, MO 65737-8875
Phone
(417) 272-3909
Fax
(417) 272-3918
NPI assigned
Jun 9, 2015
Sex
Male
Sole proprietor
No

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 and National Provider Directory roles.

Medicare Care Compare profile

Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1505 S Elliott Ave
Suite E
Aurora, MO 65605-2155
Phone (417) 308-0095

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MO

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20150731016604 MO Practitioner - Physical Therapist in Private Practice 9032423249 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
BT Acquisitions, LLC Physical Therapist Current
since Nov 25, 2019
Accepting new patients

Locations

1505 S Elliott Ave
Ste E
Aurora, MO 65605
Phone (417) 308-0095

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2015017509 MO Yes

Addresses

Primary practice location

16282 State Highway 13 Ste F
Branson West, MO 65737-8875

Mailing address

427 S Mill St
Rogersville, MO 65742-7601
Phone (417) 753-7735

Other providers in Branson West, MO

All providers in Branson West, MO · Physical Therapist in Missouri

Sources for this page

Verify at the official NPI Registry.