Individual provider Active NPI

Brooke Hansen, DPT

  • Physical Therapist
  • Charleston, SC
National Provider Identifier
1699454397
Registry record updated Jul 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
2267 Ashley River Rd
Charleston, SC 29414-4736
Phone
(843) 576-4121
Fax
(843) 576-4121
NPI assigned
Jul 12, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2023

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 Primary

Addresses

Primary practice location

2267 Ashley River Rd
Charleston, SC 29414-4736

Mailing address

5111 N Rhett Ave
North Charleston, SC 29405-4219
Phone (843) 804-9479

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241121003482 IL Practitioner - Physical Therapist in Private Practice 7618339896 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Emory University School of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fox Valley Physical Therapy and Wellness,LLCGroup PAC ID 2769677608, 8 clinicians

Practice addresses (Care Compare)

3381 W Main St
Suite 1
St Charles, IL 60175-1008
Phone (630) 549-0511

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11936SCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Valley Physical Therapy and Wellness,LLC Physical Therapist CurrentSince Nov 18, 2024 Accepting new patients
Love of Language PastSince May 8, 2018 Accepting new patients

Locations

3381 W Main St
Ste 1
St Charles, IL 60175
Phone (630) 377-7788

Organizations & group practices 2

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": "1689120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690156800000",
    "number": "1699454397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5111 N RHETT AVE",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294054219",
            "telephone_number": "843-804-9479",
            "fax_number": "843-804-9020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2267 ASHLEY RIVER RD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294144736",
            "telephone_number": "843-576-4121",
            "fax_number": "843-576-4121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSEN",
        "first_name": "BROOKE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-12",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2023; 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.