Individual provider Active NPI

Brandon Dean, PTA

  • Physical Therapy Assistant
  • Valdosta, GA
National Provider Identifier
1316699408
Registry record updated Jan 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA004398 Issued in GA
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

Updated by the provider on Jan 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
PTA004398GAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Valdosta Orthopedic Associates PC CurrentSince Jan 26, 2022 Accepting new patients

Locations

3520 N Crossing Cir
Valdosta, GA 31602
Phone (229) 242-8394

Interoperability endpoints

  • FHIR API: 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.

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": []
}

Other providers in Valdosta, GA

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.

Verify at the official NPI Registry.