Individual provider Active NPI

Brandi Norman

  • Physical Therapist
  • Luverne, AL
National Provider Identifier
1407499833
Registry record updated Aug 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTH4812 Issued in AL
Practice address
852 S Forest Ave
Luverne, AL 36049-7016
Phone
(334) 203-7773
Fax
(334) 246-2233
NPI assigned
Oct 17, 2019
Last updated
Aug 6, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PTH4812 AL Primary

Addresses

Primary practice location

852 S Forest Ave
Luverne, AL 36049-7016

Mailing address

251 Johnston St SE Ste 200
Decatur, AL 35601-2515
Phone (256) 350-1764

Other names 1

  • Brandi Bouthwell Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191209002769 AL Practitioner - Physical Therapist in Private Practice 1153754932 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Encore Rehabilitation, IncGroup PAC ID 3577462126, 182 clinicians

Practice addresses (Care Compare)

404 N Main St
Enterprise, AL 36330-2563
Phone (334) 308-9797

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PTH4812ALMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Encore Rehabilitation, Inc Physical Therapist CurrentSince Oct 1, 2019 Accepting new patients
Encore Rehabilitation, Inc. Physical Therapist CurrentSince Oct 1, 2019 Accepting new patients

Locations

251 Johnston St SE
Ste 300
Decatur, AL 35601
Phone (256) 340-9708

404 N Main St
Enterprise, AL 36330
Phone (334) 308-9797

852 S Forest Ave
Luverne, AL 36049
Phone (334) 203-7773

Organizations & group practices 2

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": "1571270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596672000000",
    "number": "1407499833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 JOHNSTON ST SE STE 200",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356012515",
            "telephone_number": "256-350-1764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "852 S FOREST AVE",
            "city": "LUVERNE",
            "state": "AL",
            "postal_code": "360497016",
            "telephone_number": "334-203-7773",
            "fax_number": "334-246-2233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORMAN",
        "first_name": "BRANDI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-17",
        "last_updated": "2020-08-06",
        "certification_date": "2020-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "PTH4812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRANDI",
            "last_name": "BOUTHWELL",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Luverne, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.