Individual provider Active NPI

Amanda Trekell Brewer, P.T.

  • Physical Therapist
  • Shreveport, LA
National Provider Identifier
1740436955
Registry record updated Mar 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
06887 Issued in LA
Practice address
663 Jordan St
Shreveport, LA 71101-4748
Phone
(318) 222-8892
Fax
(318) 222-8893
NPI assigned
Aug 7, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2014

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 06887 LA Primary

Addresses

Primary practice location

663 Jordan St
Shreveport, LA 71101-4748

Mailing address

663 Jordan St
Shreveport, LA 71101-4748
Phone (318) 222-8892

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080908000004 LA Practitioner - Physical Therapist in Private Practice 8022184506 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Brewer Physical Therapy & Associates LLC CurrentSince Aug 18, 2008 Accepting new patients
Select Physical Therapy Texas Limited Partnership Past Accepting new patients

Locations

700 Stockwell Rd
Ste 400
Bossier City, LA 71111
Phone (318) 747-2911

4970 Barksdale Blvd
Ste 900
Bossier City, LA 71112
Phone (318) 747-8892

101 Mbl Bank Dr
Minden, LA 71055
Phone (318) 639-9536

663 Jordan St
Shreveport, LA 71101
Phone (318) 222-8892

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": "1218067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395273600000",
    "number": "1740436955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "663 JORDAN ST",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014748",
            "telephone_number": "318-222-8892",
            "fax_number": "318-222-8893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "663 JORDAN ST",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014748",
            "telephone_number": "318-222-8892",
            "fax_number": "318-222-8893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREWER",
        "first_name": "AMANDA",
        "middle_name": "TREKELL",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-07",
        "last_updated": "2014-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "06887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.