Individual provider Active NPI

Jeremy Brown, DPT

  • Physical Therapist
  • San Antonio, TX
National Provider Identifier
1730604307
Registry record updated Aug 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1293285 Issued in TX
Practice address
24165 W Interstate 10 Ste 202
San Antonio, TX 78257-1160
Phone
(210) 698-1919
Fax
(210) 698-6919
NPI assigned
Aug 4, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2017

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 1293285 TX Primary

Addresses

Primary practice location

24165 W Interstate 10 Ste 202
San Antonio, TX 78257-1160

Mailing address

646 George St
Clare, MI 48617-9413
Phone (989) 424-6300

Other identifiers 1

IdentifierTypeStateIssuer
1293285OtherTXSTATE LICENSE

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1501804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501804800000",
    "number": "1730604307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "646 GEORGE ST",
            "city": "CLARE",
            "state": "MI",
            "postal_code": "486179413",
            "telephone_number": "989-424-6300",
            "fax_number": "989-424-6302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24165 W INTERSTATE 10 STE 202",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782571160",
            "telephone_number": "210-698-1919",
            "fax_number": "210-698-6919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "JEREMY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-04",
        "last_updated": "2017-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1293285",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "1293285",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2017; 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.