Individual provider Active NPI

Emily Marie Brown

  • Physical Therapist
  • Pacific, MO
National Provider Identifier
1740918309
Registry record updated Aug 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2022030861 Issued in MO
Practice address
295 N Western Ave
Pacific, MO 63069-1186
Phone
(636) 271-9995
Fax
(636) 271-9151
NPI assigned
Aug 11, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2022

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 2022030861 MO Primary

Addresses

Primary practice location

295 N Western Ave
Pacific, MO 63069-1186

Mailing address

848 Country Stone Dr
Manchester, MO 63021-7063
Phone (314) 550-1955

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

LicenseStateTypeSpecialty
2022030861MOMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Select Rehab St. Louis, LLC PastSince Aug 14, 2022 Accepting new patients
SSM Select Rehab St Louis LLC PastSince Aug 14, 2022 Accepting new patients

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": "1660176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660176000000",
    "number": "1740918309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "848 COUNTRY STONE DR",
            "city": "MANCHESTER",
            "state": "MO",
            "postal_code": "630217063",
            "telephone_number": "314-550-1955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 N WESTERN AVE",
            "city": "PACIFIC",
            "state": "MO",
            "postal_code": "630691186",
            "telephone_number": "636-271-9995",
            "fax_number": "636-271-9151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "EMILY",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-11",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2022030861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pacific, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2022; 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.