Brandon K Richards, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

7620 Issued in ID

Practice address

4765 S Durango Dr
106
Las Vegas, NV 89147-8145

Phone

(702) 898-7633

Fax

(702) 898-6433

NPI assigned

May 17, 2011

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Brandon Jackson PT

  • Sports Physical Therapist
  • Las Vegas, NV
  • NPI 1205266764
  NPD (past)
• Brandon Jackson, P T

  • Physical Therapist
  • Las Vegas, NV
  • NPI 1487682076
  NPD (past)

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

{
    "created_epoch": "1305590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629849600000",
    "number": "1164715652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 WHITE AVE",
            "city": "MOSCOW",
            "state": "ID",
            "postal_code": "838433932",
            "telephone_number": "208-882-1426",
            "fax_number": "208-882-1428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4765 S DURANGO DR",
            "address_2": "106",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891478145",
            "telephone_number": "702-898-7633",
            "fax_number": "702-898-6433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDS",
        "first_name": "BRANDON",
        "middle_name": "K",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-17",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "7620",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richards Cosmetic Surgery, Inc
• Richards Psychological Services PLLC
• Alicia A Richards
• Amina K Richards
• Audrey Mae Richards
• Brigitte Richards
• Bryson Gibbs Richards, M.D.
• Cassandra Richards, ED.D
• Christopher Mark Richards, DO
• Clarissa Richards

• Physical Therapist in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Physical Therapist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 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.