Individual provider Active NPI

Cowan Brown, DPT

  • Physical Therapist
  • Lisle, IL
National Provider Identifier
1750757092
Registry record updated Dec 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070021633 Issued in IL
Practice address
4300 Lincoln Ave Unit B
Lisle, IL 60532-1210
Phone
(630) 281-2900
Fax
(630) 281-2901
NPI assigned
Aug 20, 2015
Last updated
Dec 13, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2019

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 070021633 IL Primary

Addresses

Primary practice location

4300 Lincoln Ave Unit B
Lisle, IL 60532-1210

Mailing address

33900 Harper Ave Ste 104
Clinton TWP, MI 48035-4258
Phone (586) 350-2644

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150911000016 IL Practitioner - Physical Therapist in Private Practice 1850608670 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2764 Aurora Ave
Suite 124
Naperville, IL 60540-1007
Phone (630) 235-4433

Merit-based Incentive Payment System (MIPS)

Final score
81.73 of 100Reported as group
Quality
87.86
Improvement activities
40
Cost
61.36

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070021633ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Physical Therapy and Wellness PLLC Physical Therapist CurrentSince Nov 23, 2023 Accepting new patients
Legacy Physical Therapy and Wellness PLLC CurrentSince Nov 23, 2023 Accepting new patients

Locations

2764 Aurora Ave
Ste 124
Naperville, IL 60540
Phone (630) 235-4433

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1440028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576195200000",
    "number": "1750757092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33900 HARPER AVE STE 104",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480354258",
            "telephone_number": "586-350-2644",
            "fax_number": "586-541-3735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 LINCOLN AVE UNIT B",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605321210",
            "telephone_number": "630-281-2900",
            "fax_number": "630-281-2901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "COWAN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-20",
        "last_updated": "2019-12-13",
        "certification_date": "2019-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070021633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lisle, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2019; 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.