Kimberly Edwina Brown, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

29635 Issued in FL

Practice address

500 Hospital Dr
Crestview, FL 32539-7355

Phone

(850) 689-3146

NPI assigned

Mar 2, 2021

Sex

Female

Sole proprietor

Yes

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": "1614643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614643200000",
    "number": "1740875731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1691 W HIGHWAY 98 APT 306",
            "city": "MARY ESTHER",
            "state": "FL",
            "postal_code": "325691561",
            "telephone_number": "828-230-5481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 HOSPITAL DR",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325397355",
            "telephone_number": "850-689-3146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "KIMBERLY",
        "middle_name": "EDWINA",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-02",
        "last_updated": "2021-03-02",
        "certification_date": "2021-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "29635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kara O Brooks, M.D.
• Savannah Brooks
• Melanie Broome, PT, CEEAA, VESTIB
• Judith M Brown, LMT
• Katherine Brown
• Troy Brown III, D.M.D.
• Tanner Brunnworth, DMD
• Justin Buchanan, D.M.D.
• Carla J Bulla, PT, DPT
• Ryan Bullard, LCSW, BCD, PMH-C

• Physical Therapy Assistant in Crestview, FL
• Providers in Crestview, FL by specialty
• Physical Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2021; 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.