Broad River Rehabilitation

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

BROAD RIVER REHABILITATION

Practice address

6302 SW Lee Blvd
Lawton, OK 73505-9103

Phone

(580) 536-6800

NPI assigned

Nov 17, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Annette Hassen

Title

Credentialing Specialist

Phone

(828) 774-5222

Specialties & licenses 3

Addresses

Other names 1

• Broad River Rehab Doing business as

Tax ID family

Broad River Rehabilitation3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Broad River Rehabilitation

  • Physical Therapist
  • Rome, GA
  • NPI 1417732835
  NPD tax ID
• Broad River Rehabilitation

  • Speech-Language Pathologist
  • Fernandina Beach, FL
  • NPI 1679283998
  NPD tax ID

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

{
    "created_epoch": "1700179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700179200000",
    "number": "1871368027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 POND ST",
            "city": "ARDEN",
            "state": "NC",
            "postal_code": "287048500",
            "telephone_number": "828-774-5222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6302 SW LEE BLVD",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735059103",
            "telephone_number": "580-536-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROAD RIVER REHABILITATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-17",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A",
        "authorized_official_last_name": "HASSEN",
        "authorized_official_first_name": "ANNETTE",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "828-774-5222"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Broad River Rehab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Crysti Brierton
• Monique M Bringman
• Sandra L Brisby, BS
• Neal Briscoe, CRNA
• Richard T Brittingham, MD
• Monica Brokaw, MS, LMFT CAND
• Brookridge Inc
• Vicki Brooks-Stinson, DPT
• Dustin Corey Brooks, PA-C
• Perry L Brooks, D.D.S.

• Physical Therapist in Lawton, OK
• Providers in Lawton, OK by specialty
• Physical Therapist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2023; 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.