Brain Fix Specialist, LLC

Primary specialty

Environmental Modification Occupational Therapy AssistantTaxonomy code 224ZE0001X

Legal business name

BRAIN FIX SPECIALIST, LLC

Practice address

503 N Main St Ste 657
Pueblo, CO 81003-3132

Phone

(719) 289-1191

NPI assigned

Sep 4, 2013

Organization subpart

No

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

Authorized official

Name

Beverly A Carlso, IMC

Title

Owner

Phone

(719) 289-1191

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1378252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378252800000",
    "number": "1730514183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 N MAIN ST STE 657",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810033132",
            "telephone_number": "719-289-1191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 N MAIN ST STE 657",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810033132",
            "telephone_number": "719-289-1191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAIN FIX SPECIALIST, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-04",
        "last_updated": "2013-09-04",
        "status": "A",
        "authorized_official_last_name": "CARLSO",
        "authorized_official_first_name": "BEVERLY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "719-289-1191",
        "authorized_official_credential": "IMC"
    },
    "taxonomies": [
        {
            "code": "224ZE0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapy Assistant, Environmental Modification",
            "state": "CO",
            "license": null,
            "primary": true
        },
        {
            "code": "225XN1300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Neurorehabilitation",
            "state": "CO",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Micheal Bradford, LAC
• Bradley W. Smith, D.O., PLLC
• J Douglas Bradley, M.D.
• Leann Bradshaw
• Garrett Wayne Bragg
• Tiffany Lynn Brainerd, M.D.
• Brandon C. Payne D.D.S., M.D., P.C.
• Ruth Helen Brandt, COTA
• John J. Brantley, M.D.
• Scott Allen Brasselero, ADDICTION COUNSELOR

• Occupational Therapy Assistant in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Occupational Therapy Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 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.