Tyler Richmond Brown, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2001001890 Issued in MO

Practice address

60 Plaza Dr
Ste Genevieve, MO 63670-1800

Phone

(573) 608-5058

Fax

(844) 912-8618

NPI assigned

May 8, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Potential Therapy Services LLCGroup PAC ID 5890065361, 12 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.

• Potential Therapy Services LLC

  • Physical Therapy Clinic/Center
  • Ste Genevieve, MO
  • NPI 1104379353

  MO

  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664323200000",
    "number": "1992918452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 PLAZA DR",
            "city": "STE GENEVIEVE",
            "state": "MO",
            "postal_code": "636701800",
            "telephone_number": "573-608-5058",
            "fax_number": "844-912-8618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 PLAZA DR",
            "city": "STE GENEVIEVE",
            "state": "MO",
            "postal_code": "636701800",
            "telephone_number": "573-608-5058",
            "fax_number": "844-912-8618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "TYLER",
        "middle_name": "RICHMOND",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-08",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2001001890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Billie Bleckler
• Jessica Ashley Blum, LPC
• Alison Lee Borowiak
• Matthew S Bosner, MD
• James L Brandt, DDS
• Kimberly L Browne, ANP
• Ryan Buchheit
• Emily Cain, PTA
• Isabel Carron, M.S., CF-SLP
• Jill Chatman, MS CCC-SLP

• All providers in Ste Genevieve, MO
• Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2022; 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.