Individual provider Active NPI

Brad Douglas Cosner, LPTA

  • Physical Therapy Assistant
  • Des Moines, IA
National Provider Identifier
1679910004
Registry record updated May 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
001201 Issued in IA
Practice address
4911 SW 19TH St
Des Moines, IA 50315-4487
Phone
(515) 285-2559
Fax
(515) 285-6487
NPI assigned
May 24, 2013
Last updated
May 24, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 001201 IA Primary

Addresses

Primary practice location

4911 SW 19TH St
Des Moines, IA 50315-4487

Mailing address

4911 SW 19TH St
Des Moines, IA 50315-4487
Phone (515) 285-2559

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
001201IAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1369353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369353600000",
    "number": "1679910004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4911 SW 19TH ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503154487",
            "telephone_number": "515-285-2559",
            "fax_number": "515-285-6487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4911 SW 19TH ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503154487",
            "telephone_number": "515-285-2559",
            "fax_number": "515-285-6487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSNER",
        "first_name": "BRAD",
        "middle_name": "DOUGLAS",
        "name_prefix": "Mr.",
        "credential": "LPTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-24",
        "last_updated": "2013-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IA",
            "license": "001201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2013; 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.