Individual provider Active NPI

Earl Braden Brasfield, M.S.P.T., O.C.S.

  • Physical Therapist
  • Saint Louis, MO
National Provider Identifier
1750562138
Registry record updated Nov 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
118376 Issued in MO
Practice address
2716 Telegraph Rd
Suite #107
Saint Louis, MO 63125-4078
Phone
(314) 894-9008
Fax
(314) 894-1232
NPI assigned
Nov 14, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2007

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 118376 MO Primary

Addresses

Primary practice location

2716 Telegraph Rd
Suite #107
Saint Louis, MO 63125-4078

Mailing address

2716 Telegraph Rd
Suite #107
Saint Louis, MO 63125-4078
Phone (314) 894-9008

Other identifiers 1

IdentifierTypeStateIssuer
488363201MedicaidMO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040629000003 MO Practitioner - Physical Therapist in Private Practice 7113903279 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2909 Telegraph Rd
Saint Louis, MO 63125-4062
Phone (314) 894-9008

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
118376MOMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic & Sports Physical Therapy, Inc. Physical Therapist CurrentSince Oct 15, 2012 Accepting new patients

Locations

2716 Telegraph Rd
Ste 107
Saint Louis, MO 63125
Phone (314) 894-9008

2909 Telegraph Rd
Saint Louis, MO 63125
Phone (314) 894-9008

Organizations & group practices 1

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": "1194998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194998400000",
    "number": "1750562138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2716 TELEGRAPH RD",
            "address_2": "SUITE #107",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631254078",
            "telephone_number": "314-894-9008",
            "fax_number": "314-894-1232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2716 TELEGRAPH RD",
            "address_2": "SUITE #107",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631254078",
            "telephone_number": "314-894-9008",
            "fax_number": "314-894-1232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRASFIELD",
        "first_name": "EARL",
        "middle_name": "BRADEN",
        "name_prefix": "Mr.",
        "credential": "M.S.P.T., O.C.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-14",
        "last_updated": "2007-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "118376",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "488363201",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.