Brad Adam Moltrup, P.T. M.S.

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

2081 N Main St
Canton, IL 61520-1032

Phone

(309) 647-6135

NPI assigned

Mar 25, 2008

Last updated

Mar 25, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Central Illinois Institute of Balance LLC

  • Physical Therapist
  • Normal, IL
  • NPI 1255478335
  NPD (past)

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

{
    "created_epoch": "1206403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206403200000",
    "number": "1871765370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 BITTERSWEET LN",
            "city": "EAST PEORIA",
            "state": "IL",
            "postal_code": "616113726",
            "telephone_number": "309-642-1575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2081 N MAIN ST",
            "city": "CANTON",
            "state": "IL",
            "postal_code": "615201032",
            "telephone_number": "309-647-6135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLTRUP",
        "first_name": "BRAD",
        "middle_name": "ADAM",
        "name_prefix": "Mr.",
        "credential": "P.T. M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-25",
        "last_updated": "2008-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Midwest Mobile Anesthesia Consultants, SC
• Brittany Nicole Miller, APRN FNP-C
• Melanie A Miller, APN
• Meredith Kay Milleson
• Miriam S Mindeman, M.A., L.P.C.
• Crystal Dawn Morse, D.C.
• James Morse II, MD
• Madison Mustread, PHARMD
• Lacey Neal
• Alicia Nelson, M.S. CCC-SLP

• Physical Therapist in Canton, IL
• Providers in Canton, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2008; 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.