Anthony Joseph Bruzzichesi, ATC

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA4657 Issued in AR

Practice address

1206 N Main St
Mountain Grove, MO 65711-1025

Phone

(417) 926-5699

NPI assigned

Jul 2, 2021

Last updated

Dec 22, 2023By 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 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Physical Therapy Specialist Clinic, Inc.

  • Physical Therapist
  • West Plains, MO
  • NPI 1659312619

  Physical Therapy Assistant

  NPD

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

{
    "created_epoch": "1625184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703203200000",
    "number": "1699346411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1480 8TH ST",
            "city": "WEST PLAINS",
            "state": "MO",
            "postal_code": "657752010",
            "telephone_number": "417-256-5669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1206 N MAIN ST",
            "city": "MOUNTAIN GROVE",
            "state": "MO",
            "postal_code": "657111025",
            "telephone_number": "417-926-5699"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1480 8th St",
            "address_purpose": "LOCATION",
            "city": "West Plains",
            "state": "MO",
            "postal_code": "657752010",
            "country_code": "US",
            "telephone_number": "417-256-5669",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRUZZICHESI",
        "first_name": "ANTHONY",
        "middle_name": "JOSEPH",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-02",
        "last_updated": "2023-12-22",
        "certification_date": "2023-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MO",
            "license": "2021037957",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "AR",
            "license": "PTA4657",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MO",
            "license": "2021024436",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christy Lin Bramwell, FNP
• Samuel Lee Brock, PHARMACIST
• Dana Brown
• Jonell Kay Brown
• Matthew Austin Brown, MD
• Paul E. Burris, FNP-C
• Heather Renee Busby, PMHNP
• Golda Cain
• Todd Robert Campbell, PHARMACIST
• Carla Clinton, FNP-C

• Physical Therapy Assistant in Mountain Grove, MO
• Providers in Mountain Grove, MO by specialty
• Physical Therapy Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2023; 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.