Broadway Ergonomics, LLC

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

2010028179 Issued in MO

Legal business name

BROADWAY ERGONOMICS, LLC

Practice address

111 E Broadway
Suite 340
Columbia, MO 65203-4208

Phone

(573) 808-2392

Fax

(888) 738-3034

NPI assigned

Jul 15, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Bret Sheridan Derrick, P.T.

Title

Partner

Phone

(573) 808-2392

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1342310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342310400000",
    "number": "1982959011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E BROADWAY",
            "address_2": "SUITE 340",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652034208",
            "telephone_number": "573-808-2392",
            "fax_number": "888-738-3034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E BROADWAY",
            "address_2": "SUITE 340",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652034208",
            "telephone_number": "573-808-2392",
            "fax_number": "888-738-3034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROADWAY ERGONOMICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-15",
        "last_updated": "2012-07-15",
        "status": "A",
        "authorized_official_last_name": "DERRICK",
        "authorized_official_first_name": "BRET",
        "authorized_official_middle_name": "SHERIDAN",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "573-808-2392",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "2251E1200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Ergonomics",
            "state": "MO",
            "license": "02148",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": "MO",
            "license": "2010028179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brinkley Isl
• Barbara Lynn Brinkman, CCC-SLP
• Jeanette A Brinkman, MSW, LMSW
• Britell, LLC
• Joshua Michael Britton, RN
• Broadway Internal Medicine Associates L.L.C.
• Broadway Urgent Care LLC
• Devara Brock-Stevens
• John J. Brockland, MD
• Elisabeth Louise Brockman-Knight, MA, LPC

• Orthopedic Physical Therapist in Columbia, MO
• Providers in Columbia, MO by specialty
• Orthopedic Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2012; 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.