Individual provider Active NPI

Daniel Musenbrock, MS,PT,CSCS

  • Physical Therapist
  • Belleville, IL
National Provider Identifier
1972708253
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
2346 Mascoutah Ave
Belleville, IL 62220-3499
Phone
(618) 277-6282
Fax
(618) 277-6284
NPI assigned
Jun 18, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 IL Primary

Addresses

Primary practice location

2346 Mascoutah Ave
Belleville, IL 62220-3499

Mailing address

2346 Mascoutah Ave
Belleville, IL 62220-3499
Phone (618) 277-6282

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
070013418ILMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972708253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2346 MASCOUTAH AVE",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622203499",
            "telephone_number": "618-277-6282",
            "fax_number": "618-277-6284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2346 MASCOUTAH AVE",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622203499",
            "telephone_number": "618-277-6282",
            "fax_number": "618-277-6284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSENBROCK",
        "first_name": "DANIEL",
        "name_prefix": "Mr.",
        "credential": "MS,PT,CSCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belleville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.