Brandon Virdell King, CSA, CSFA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

Practice address

55 Atlanta St SE Ste 204
Marietta, GA 30060-1977

Phone

(678) 517-3428

Fax

(770) 485-1534

NPI assigned

Nov 25, 2009

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Olympian Surgical Assistants

  • Surgical Physician Assistant
  • Marietta, GA
  • NPI 1366978991
  NPD Authorized official

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

{
    "created_epoch": "1259107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637712000000",
    "number": "1033447313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 81",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300610081",
            "telephone_number": "678-517-3428",
            "fax_number": "770-485-1534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 ATLANTA ST SE STE 204",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601977",
            "telephone_number": "678-517-3428",
            "fax_number": "770-485-1534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "BRANDON",
        "middle_name": "VIRDELL",
        "name_prefix": "Mr.",
        "credential": "CSA, CSFA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-11-25",
        "last_updated": "2021-11-24",
        "certification_date": "2021-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Felicia Cohila Kincaid, RN
• William R. Kincer, D.M.D.
• Kindred Soul Health
• Kinesthetic Physical Therapy, LLC
• Alexis King
• Carisa Chree King, MASSAGE THERAPIST
• Colin King, MD
• Evan King, RNFA
• Kenly King
• Kristen Howze King, AUD

• Surgical Physician Assistant in Marietta, GA
• Providers in Marietta, GA by specialty
• Surgical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2021; 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.