Brenda Michele Davis, LPTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

8354 Issued in TN

Practice address

4081 Thornton Taylor Pkwy
Fayetteville, TN 37334-2674

Phone

(931) 433-9973

NPI assigned

Oct 24, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1698105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698105600000",
    "number": "1356113286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143 MOLINO RD",
            "city": "FAYETTEVILLE",
            "state": "TN",
            "postal_code": "373346246",
            "telephone_number": "205-936-2923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4081 THORNTON TAYLOR PKWY",
            "city": "FAYETTEVILLE",
            "state": "TN",
            "postal_code": "373342674",
            "telephone_number": "931-433-9973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "BRENDA",
        "middle_name": "MICHELE",
        "credential": "LPTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-24",
        "last_updated": "2023-10-24",
        "certification_date": "2023-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TN",
            "license": "8354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jimmy M Daniel, D.D.S.
• Sandra Kilburn Daniel, ACNP-BC
• William Daniel, AGACNP-BC
• Dash Transport LLC
• Lesley K Davidson, RN
• Daniel Dejarnatt, OD
• Doctor Mike LLC
• Lacorya Yvonne Donley, FNP-C
• Alan B Drewry, DDS
• Kay D. Eason, MED/CCC-SLP

• Physical Therapy Assistant in Fayetteville, TN
• Providers in Fayetteville, TN by specialty
• Physical Therapy Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2023; 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.