Jacob Thomas Adam Brannon, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

307089 Issued in CA

Practice address

6070 Avenida Encinas # 100
Carlsbad, CA 92011-1001

Phone

(760) 388-6475

NPI assigned

Dec 9, 2024

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 CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2024

Medicare assignment

May accept Medicare assignment

Group practices

Proactive Physical Therapy and Sports Medicine IncGroup PAC ID 1557369436, 51 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Proactive Physical Therapy & Sports Medicine Inc

  • Physical Therapy Clinic/Center
  • Carlsbad, CA
  • NPI 1285729509

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• DPT Holdings PLLC

  • Physical Therapist
  • Plainfield, IL
  • NPI 1689648602

  CA

  Medicare reassignment NPD

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

{
    "created_epoch": "1733702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733702400000",
    "number": "1073329504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6070 AVENIDA ENCINAS # 100",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920111001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6070 AVENIDA ENCINAS # 100",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920111001",
            "telephone_number": "760-388-6475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANNON",
        "first_name": "JACOB",
        "middle_name": "THOMAS ADAM",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-12-09",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "307089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Leigh Bradley
• Lana Bradley, LIC.AC.,DIPL
• Alisa Brady, PHD
• Kelsey Branch
• Claire Brandeburg, LMFT
• Phyllis Kathryn Branson, L.M., C.P.M.
• Amanda Brawley
• Samantha Breckon
• Kenneth Eugene Breeding, PH.D., MFT
• Mark Breese, DMD

• Physical Therapist in Carlsbad, CA
• Providers in Carlsbad, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2024; 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.