Healthcare Provider Details

I. General information

NPI: 1609249051
Provider Name (Legal Business Name): BRADEN NELSON SCHAIDT PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2015
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 JOHNSTOWN DR
ROGERSVILLE MO
65742-9366
US

IV. Provider business mailing address

113 JOHNSTOWN DR
ROGERSVILLE MO
65742-9366
US

V. Phone/Fax

Practice location:
  • Phone: 417-753-7735
  • Fax: 417-753-7765
Mailing address:
  • Phone: 417-753-7735
  • Fax: 417-753-7765

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2024020845
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: