Bradley Libby, DPT

Primary specialty

SpecialistTaxonomy code 174400000X

License

PT4035 Issued in ME

Practice address

797 Wilson St
Brewer, ME 04412-1000

Phone

(207) 992-4042

Fax

(207) 992-4043

NPI assigned

Aug 22, 2013

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ME

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Performance Physical Therapy and Sports Rehab IncGroup PAC ID 1052632932, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Performance Physical Therapy and Sports Rehab Inc.

  • Physical Therapist
  • Bangor, ME
  • NPI 1215333554
  Medicare reassignment Care Compare group NPD Authorized official
• Back in Motion Physical Therapy, LLC

  • Physical Therapist
  • Gorham, ME
  • NPI 1821165960
  NPD (past)

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

{
    "created_epoch": "1377129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377129600000",
    "number": "1932533262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "797 WILSON ST",
            "city": "BREWER",
            "state": "ME",
            "postal_code": "044121000",
            "telephone_number": "207-992-4042",
            "fax_number": "207-992-4043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "797 WILSON ST",
            "city": "BREWER",
            "state": "ME",
            "postal_code": "044121000",
            "telephone_number": "207-992-4042",
            "fax_number": "207-992-4043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIBBY",
        "first_name": "BRADLEY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-22",
        "last_updated": "2013-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "ME",
            "license": "PT4035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY LICENCE",
            "identifier": "PT4035",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James M Lapierre, LCSW
• Abigail Grace Lawrence, OTR/L
• Deborah Lee, APRN
• Mary Ellen Lee
• Kristen Lepage, DPT
• Anthony L Liberatore, D.M.D.
• Joanna Cates Liberatore, FNP-C
• Linda M Orlando LLC
• Livin' the Breast Life, LLC
• Lalaine C Llanto, MD

• Specialist in Brewer, ME
• Providers in Brewer, ME by specialty
• Specialist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2013; 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.