Individual provider Active NPI

Stephanie Broadhurst, DPT

  • Physical Therapist
  • Keokuk, IA
National Provider Identifier
1912306556
Registry record updated Feb 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
073175 Issued in IA
Practice address
225 Main St
Keokuk, IA 52632-5837
Phone
(319) 524-4900
Fax
(319) 524-4895
NPI assigned
Aug 20, 2014
Last updated
Feb 6, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2020

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 073175 IA Primary

Addresses

Primary practice location

225 Main St
Keokuk, IA 52632-5837

Mailing address

225 Main St
Keokuk, IA 52632-5837
Phone (319) 524-4900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20141013000718 IA Practitioner - Physical Therapist in Private Practice 5092935122 Reassigns benefits to 3 organizations
I20170501001913 MO Practitioner - Physical Therapist in Private Practice 5092935122 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athletico LTDGroup PAC ID 4789602681, 2,187 clinicians

Practice addresses (Care Compare)

3252 Ridge PT
Bettendorf, IA 52722-5312
Phone (563) 332-4995

720 W US Hwy 18
Suite B Athletico Physical Therapy
Garner, IA 50438-1022
Phone (641) 924-0205

Merit-based Incentive Payment System (MIPS)

Final score
86.32 of 100Reported as group
Quality
84.44
Promoting interoperability
99
Improvement activities
40
Cost
70.78

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Athletico LTD Physical Therapist CurrentSince Apr 29, 2024 Accepting new patients
Advance Hannibal Regional Hospital LLC Physical Therapist CurrentSince May 1, 2017 Accepting new patients
Advance PT-Blessing Corp Services-Ft Madison Community Hosp Physical Therapist CurrentSince Jan 1, 2016 Accepting new patients
Empowerme Asl, LLC Physical Therapist CurrentSince Nov 17, 2023 Accepting new patients
Advance Hannibal Regional Hospital, LLC Physical Therapist CurrentSince May 1, 2017 Accepting new patients
Empowerme Asl, LLC CurrentSince Nov 17, 2023 Accepting new patients
Athletico LTD Physical Therapist CurrentSince Apr 29, 2024 Accepting new patients

Locations

3252 Ridge Pt
Bettendorf, IA 52722
Phone (563) 332-4995

225 Main St
Keokuk, IA 52632
Phone (319) 524-4900

2122 York Rd
Ste 300
Oak Brook, IL 60523
Phone (630) 575-6250

1804 Elm St
Canton, MO 63435
Phone (573) 288-3311

160 Progress Rd
#111
Hannibal, MO 63401

188 Medical Dr
#A
Hannibal, MO 63401
Phone (573) 406-0576

1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 673-6765

Organizations & group practices 7

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": "1408492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580947200000",
    "number": "1912306556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 MAIN ST",
            "city": "KEOKUK",
            "state": "IA",
            "postal_code": "526325837",
            "telephone_number": "319-524-4900",
            "fax_number": "319-524-4895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 MAIN ST",
            "city": "KEOKUK",
            "state": "IA",
            "postal_code": "526325837",
            "telephone_number": "319-524-4900",
            "fax_number": "319-524-4895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROADHURST",
        "first_name": "STEPHANIE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-20",
        "last_updated": "2020-02-06",
        "certification_date": "2020-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "073175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Keokuk, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2020; 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.