Brooke Nicole Mansour, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

09109 Issued in OH

Practice address

3702 Cook Rd
Medina, OH 44256-9289

Phone

(330) 416-3388

NPI assigned

Mar 18, 2016

Last updated

Mar 18, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1458259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458259200000",
    "number": "1730540618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3702 COOK RD",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442569289",
            "telephone_number": "330-416-3388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3702 COOK RD",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442569289",
            "telephone_number": "330-416-3388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANSOUR",
        "first_name": "BROOKE",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-18",
        "last_updated": "2016-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OH",
            "license": "09109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Molly A Mallory
• Rebecca Marie Mancini
• Nicole Mancuso, ED. S.
• Norah A Mangan, QMHS MA CMS MA
• Aaron J Mann
• Jesse Marandola
• Marc Glassman Inc (Marcs)
• Kristen Elizabeth Marcum, DO
• Lindsay Marie, OTR/L
• Mark J Stubbendieck DC Inc

• Physical Therapy Assistant in Medina, OH
• Providers in Medina, OH by specialty
• Physical Therapy Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2016; 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.