MEDICARE: JESSICA RAE BROWN DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2251P0200X	Pediatric Physical Therapist	PTH4618	AL
2	2251P0200X	Pediatric Physical Therapist		GA
3	2251P0200X	Pediatric Physical Therapist	7981	SC

General Provider Information

NPI Number	:	1649241779
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA RAE BROWN DPT

Provider Business Mailing Address
First Line	:	829 SW LEMANS LN
Second Line	:
City	:	LEES SUMMIT
State	:	MO
Zip	:	64082-4618
Country	:	US
Telephone Number	:	816-352-9461
Fax Number	:	816-817-0501

Provider Business Practice Location Address
First Line	:	829 SW LEMANS LN
Second Line	:
City	:	LEES SUMMIT
State	:	MO
Zip	:	64082-4618
Country	:	US
Telephone Number	:	816-352-9461
Fax Number	:	816-817-0501

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/27/2006
Last Update Date	:	07/29/2025

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