Brandon Bullock

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT014444 Issued in GA

Practice address

12050 Highway 92 Ste 116
Woodstock, GA 30188-4287

Phone

(770) 516-3072

NPI assigned

Oct 28, 2019

Sex

Male

Sole proprietor

No

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.

• Benchmark Physical Therapy, Inc

  • Physical Therapy Clinic/Center
  • Duluth, GA
  • NPI 1083666903

  GA

  Medicare reassignment NPD
• Drayer Physical Therapy Georgia LLC

  • Physical Therapist
  • Loganville, GA
  • NPI 1962830406

  GA, Physical Therapist

  Medicare reassignment NPD
• Independent Physical Therapy of Georgia, LLC

  • Physical Therapist
  • Fort Oglethorpe, GA
  • NPI 1780636068

  GA, Physical Therapist

  Medicare reassignment NPD
• Benchmark Physical Therapy Inc

  • Physical Therapist
  • Riverdale, GA
  • NPI 1427000777
  NPD
• Independent Physical Therapy of Georgia, LLC

  • Occupational Therapist
  • Gainesville, GA
  • NPI 1306013941

  Physical Therapist

  NPD

Medicare fee-for-service enrollment

Enrolled in GA

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 6, 2022.

{
    "created_epoch": "1572220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641427200000",
    "number": "1114560604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6397 LEE HWY",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374212564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12050 HIGHWAY 92 STE 116",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301884287",
            "telephone_number": "770-516-3072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLOCK",
        "first_name": "BRANDON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-28",
        "last_updated": "2022-01-06",
        "certification_date": "2022-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT014444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Buckhault, MED., BCBA
• Brandie Buckner
• Elise Bugenske, OD
• Savannah Buice
• Molly Bullard, RBT
• Leah Ann Bulow, MSPT
• Amanda Marie Burns, DC
• Ginger Burns, MSW
• Meredith Burns, PSY.D.
• Payton Burpee

• All providers in Woodstock, GA
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2022; 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.