Active NPI
Brandon Dean, PTA
- Physical Therapy Assistant
- Valdosta, GA
National Provider Identifier
1316699408
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- PTA004398
- Practice address
- 3520 N Crossing Cir
Valdosta, GA 31602-1067 - Phone
- (229) 242-8394
- NPI assigned
- Jan 20, 2022
- Sex
- Male
- 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 Therapy Assistant | 225200000X | PTA004398 | GA | Primary |
Addresses
Primary practice location
3520 N Crossing Cir
Valdosta, GA 31602-1067
Mailing address
4203 Spring Brook Cir
Valdosta, GA 31602-6751
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTA004398 | GA | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Valdosta Orthopedic Associates PC | Current | Accepting new patients |
Locations
3520 N Crossing Cir
Valdosta, GA 31602
Phone (229) 242-8394
Interoperability endpoints
- https://api.platform.athenahealth.com/11118/brand/5/csg/22/fhir/r4
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Valdosta Orthopedic Associates
- Orthopaedic Surgery Physician
- Valdosta, GA
- NPI 1053457457
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1642636800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642636800000",
"number": "1316699408",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4203 SPRING BROOK CIR",
"city": "VALDOSTA",
"state": "GA",
"postal_code": "316026751"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3520 N CROSSING CIR",
"city": "VALDOSTA",
"state": "GA",
"postal_code": "316021067",
"telephone_number": "229-242-8394"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEAN",
"first_name": "BRANDON",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-01-20",
"last_updated": "2022-01-20",
"certification_date": "2022-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "GA",
"license": "PTA004398",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
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- Daniel Day
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- Dca of So Ga LLC (U S Renal Care South Georgia Dialysis)
- Ashley De Plato
- Raymond Dean, LPC
- Deanna Folsom LCSW PC
- Deborah F McDonald OD PC (North Oak Family Eye Care & Optical)
- Meredith Emily Decesare, NP-C
- Katie Rackley Decoudres, M.ED., CCC-SLP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.