Active NPI
Brooke Maury Dudley
- Physical Therapist
- Anchorage, AK
National Provider Identifier
1730718412
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1587
- Practice address
- 3000 McCollie Ave
Anchorage, AK 99517-1270 - Phone
- (907) 223-1538
- NPI assigned
- Apr 5, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1587 | AK | Primary |
Addresses
Primary practice location
3000 McCollie Ave
Anchorage, AK 99517-1270
Mailing address
3000 McCollie Ave
Anchorage, AK 99517-1270
Phone (907) 223-1538
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1587 | AK | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1586044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1586044800000",
"number": "1730718412",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3000 MCCOLLIE AVE",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995171270",
"telephone_number": "907-223-1538"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3000 MCCOLLIE AVE",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995171270",
"telephone_number": "907-223-1538"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUDLEY",
"first_name": "BROOKE",
"middle_name": "MAURY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-04-05",
"last_updated": "2020-04-05",
"certification_date": "2020-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AK",
"license": "1587",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anchorage, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.