Cassandra Renee Lietzau-Mourer, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2016023404 Issued in MO

Practice address

602 Maple Valley Dr
Farmington, MO 63640

Phone

(573) 756-2999

Fax

(573) 756-6195

NPI assigned

Jul 5, 2016

Last updated

Jun 11, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Cassandra Braddy Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Farmington Sports and Rehabilitation Joint Venture

  • Rehabilitation Clinic/Center
  • Farmington, MO
  • NPI 1568513646
  NPD (past)
• Potential Therapy Services LLC

  • Physical Therapy Clinic/Center
  • Ste Genevieve, MO
  • NPI 1104379353
  NPD (past)

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

{
    "created_epoch": "1467676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528675200000",
    "number": "1982056727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 MAPLE VALLEY DR",
            "city": "FARMINGTON",
            "state": "MO",
            "postal_code": "636401976",
            "telephone_number": "573-756-2999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 MAPLE VALLEY DR",
            "city": "FARMINGTON",
            "state": "MO",
            "postal_code": "63640",
            "telephone_number": "573-756-2999",
            "fax_number": "573-756-6195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIETZAU-MOURER",
        "first_name": "CASSANDRA",
        "middle_name": "RENEE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-05",
        "last_updated": "2018-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2016023404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CASSANDRA",
            "last_name": "BRADDY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Amanda Leftridge, MSW, LMSW
• Julie Leslie, D.D.S.
• William Nate Letterman, MSW, LCSW
• Elizabeth Marie Levall, B.S.
• Zongshan Liao, DPT
• Lifenet, Inc. (KidsFlight)
• Lincare Inc. (Medical West Respiratory Services)
• Barbara Lindell, LPC
• Kyle Lindsey
• Laura Ann Lohman, PHARM.D

• Physical Therapist in Farmington, MO
• Providers in Farmington, MO by specialty
• Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2018; 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.