Brandon Edwards, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT40632 Issued in FL

Practice address

15751 San Carlos Blvd Ste 4
Fort Myers, FL 33908-3315

Phone

(239) 337-2739

NPI assigned

Aug 15, 2023

Last updated

Aug 15, 2023By the provider in NPPES

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 FL

Enrollment records 1

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Back in Motion Sport & Spine Physical Therapy LLC

  • Physical Therapist
  • Fort Myers, FL
  • NPI 1831616416
  NPD
• Concepts in Rehab Inc

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Fort Myers, FL
  • NPI 1558458273
  NPD (past)

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

{
    "created_epoch": "1692057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1003699976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3419 FORUM BLVD APT 325",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339056005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15751 SAN CARLOS BLVD STE 4",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339083315",
            "telephone_number": "239-337-2739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "BRANDON",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-08-15",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT40632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Antavian Edison
• Keren Edison, RN
• Rhiannon Alexis Edman
• Eduardo Correa DDS PA
• Cynthia Edwards-Tuttle, APRN
• Brenda Girven Edwards
• Cynthia M Edwards, CRNA
• Dustin Scot Edwards, PHARM D.
• Jill Ellen Edwards, CNM
• Johnathan William Edwards, D.C.

• Physical Therapist in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.