Brandy Anne Petty, M.S., ATC, LAT

Primary specialty

Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X

License

AT001014 Issued in GA

Practice address

Georgia Southern University Hanner Fieldhouse
Herty Drive
Statesboro, GA 30460-0001

Phone

(912) 486-7581

Fax

(912) 486-7690

NPI assigned

May 1, 2007

Sex

Female

Sole proprietor

No

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

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376764340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 N KEVIN CT",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304612743",
            "telephone_number": "912-486-7581",
            "fax_number": "912-486-7690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "GEORGIA SOUTHERN UNIVERSITY HANNER FIELDHOUSE",
            "address_2": "HERTY DRIVE",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304600001",
            "telephone_number": "912-486-7581",
            "fax_number": "912-486-7690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTY",
        "first_name": "BRANDY",
        "middle_name": "ANNE",
        "name_prefix": "Miss",
        "credential": "M.S., ATC, LAT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "GA",
            "license": "AT001014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paige Jontee Perry
• Victoria Perry
• Caroline Eliabeth Peterson
• Richard Petrella Sr., MD
• Victoria Pettofrezzo, PT, DPT
• Heather Petty
• Philip L Bertucci,MD,LLC
• Allison Paige Phillips
• Loriann Leggett Phillips, M.S, LAT, ATC
• Matthew Phillips, MD

• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Statesboro, GA
• Providers in Statesboro, GA by specialty
• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.