Active NPI
Brandy Gustafson, PT
- Physical Therapist
- Amarillo, TX
National Provider Identifier
1295273282
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1114619
- Practice address
- 3440 Bell St
Suite 306
Amarillo, TX 79109-4147 - Phone
- (806) 331-6084
- Fax
- (806) 331-6085
- NPI assigned
- Feb 9, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1114619 | TX | Primary |
Addresses
Primary practice location
3440 Bell St
Suite 306
Amarillo, TX 79109-4147
Mailing address
PO Box 1178
Panhandle, TX 79068-1178
Phone (806) 672-6520
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1114619 | TX | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1486598400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1486598400000",
"number": "1295273282",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1178",
"city": "PANHANDLE",
"state": "TX",
"postal_code": "790681178",
"telephone_number": "806-672-6520"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3440 BELL ST",
"address_2": "SUITE 306",
"city": "AMARILLO",
"state": "TX",
"postal_code": "791094147",
"telephone_number": "806-331-6084",
"fax_number": "806-331-6085"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUSTAFSON",
"first_name": "BRANDY",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-02-09",
"last_updated": "2017-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1114619",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Amarillo, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.