Active NPI
Geoffrey Brannon Poole
- Physical Therapy Assistant
- Marianna, FL
National Provider Identifier
1336900265
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- Practice address
- 4540 Lafayette St
Marianna, FL 32446-3202 - Phone
- (334) 791-5865
- NPI assigned
- Jan 18, 2024
- 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 | Primary |
Addresses
Primary practice location
4540 Lafayette St
Marianna, FL 32446-3202
Mailing address
4381 Kimberly Cir
Tallahassee, FL 32309-9622
Phone (334) 791-5865
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Critical Rehab Corporation | Physical Therapy Assistant | Past | Accepting new patients |
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1705536000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1705536000000",
"number": "1336900265",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4381 KIMBERLY CIR",
"city": "TALLAHASSEE",
"state": "FL",
"postal_code": "323099622",
"telephone_number": "334-791-5865"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4540 LAFAYETTE ST",
"city": "MARIANNA",
"state": "FL",
"postal_code": "324463202",
"telephone_number": "334-791-5865"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POOLE",
"first_name": "GEOFFREY",
"middle_name": "BRANNON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-01-18",
"last_updated": "2024-01-18",
"certification_date": "2024-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marianna, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.