Individual provider Active NPI

Brandon L Hostetler, PT, DPT

  • Physical Therapist
  • Knoxville, TN
National Provider Identifier
1205295987
Registry record updated May 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
10764 Issued in TN
Practice address
813 Kermit Dr
Knoxville, TN 37912-3861
Phone
(865) 622-5043
Fax
(865) 622-5066
NPI assigned
Feb 23, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 2, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 10764 TN Primary

Addresses

Primary practice location

813 Kermit Dr
Knoxville, TN 37912-3861

Mailing address

813 Kermit Dr
Knoxville, TN 37912-3861
Phone (865) 622-5043

Other practice location 1

5101 Marguerite Rd
Knoxville, TN 37912-5411
Phone (865) 622-5043

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10764TNMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1456185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525219200000",
    "number": "1205295987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "813 KERMIT DR",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379123861",
            "telephone_number": "865-622-5043",
            "fax_number": "865-622-5066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "813 KERMIT DR",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379123861",
            "telephone_number": "865-622-5043",
            "fax_number": "865-622-5066"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5101 Marguerite Rd",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379125411",
            "country_code": "US",
            "telephone_number": "865-622-5043",
            "fax_number": "865-622-5066",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOSTETLER",
        "first_name": "BRANDON",
        "middle_name": "L",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-02-23",
        "last_updated": "2018-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "10764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2018; 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.