Individual provider Active NPI

Brady Scott Stokes, PT, DPT, CIDN

  • Physical Therapist
  • Evanston, WY
National Provider Identifier
1972074607
Registry record updated Dec 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1497 Issued in WY
Practice address
195 Feather Way
Evanston, WY 82930-9352
Phone
(307) 679-4959
NPI assigned
Dec 6, 2018
Last updated
Dec 6, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2018

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 1497 WY Primary

Addresses

Primary practice location

195 Feather Way
Evanston, WY 82930-9352

Mailing address

3792 Almy Road 107
Evanston, WY 82930-8940
Phone (307) 679-4959

Other practice location 1

3792 Almy Road 107
Evanston, WY 82930-8940
Phone (307) 679-4959

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190514001367 WY Practitioner - Physical Therapist in Private Practice 9436492501 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Blacks Fork Physical Therapy LLCGroup PAC ID 4284977349, 2 clinicians

Practice addresses (Care Compare)

195 Feather Way
Stop 400
Evanston, WY 82930-9352
Phone (307) 224-7940

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1497WYMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
High Desert Wound Solutions, LLC Physical Therapist Current Accepting new patients
Blacks Fork Physical Therapy LLC Physical Therapist CurrentSince Feb 1, 2019 Accepting new patients

Locations

195 Feather Way
Evanston, WY 82930
Phone (307) 200-9200

195 Feather Way
Stop 400
Evanston, WY 82930
Phone (307) 224-7940

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": "1544054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544054400000",
    "number": "1972074607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3792 ALMY ROAD 107",
            "city": "EVANSTON",
            "state": "WY",
            "postal_code": "829308940",
            "telephone_number": "307-679-4959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 FEATHER WAY",
            "city": "EVANSTON",
            "state": "WY",
            "postal_code": "829309352",
            "telephone_number": "307-679-4959"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3792 Almy Road 107",
            "address_purpose": "LOCATION",
            "city": "Evanston",
            "state": "WY",
            "postal_code": "829308940",
            "country_code": "US",
            "telephone_number": "307-679-4959",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STOKES",
        "first_name": "BRADY",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "PT, DPT, CIDN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-12-06",
        "last_updated": "2018-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WY",
            "license": "1497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2018; 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.