Brandon Medical Group LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

BRANDON MEDICAL GROUP LLC

Practice address

3766 Chapel CV
Douglasville, GA 30135-2885

Phone

(770) 892-8332

Fax

(470) 401-1105

NPI assigned

Mar 3, 2022

Last updated

Mar 3, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Terrence BrandonNPI 1346705456

Title

Owner

Phone

(770) 743-8036

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Brandon Medical Group LLC Former legal business name

Electronic endpoints 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Terrence Brandon

  • Home Health Agency
  • Fairburn, GA
  • NPI 1346705456
  NPD Authorized official

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

{
    "created_epoch": "1646265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646265600000",
    "number": "1417604174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3766 CHAPEL CV",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301352885",
            "telephone_number": "770-892-8332",
            "fax_number": "470-401-1105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3766 CHAPEL CV",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301352885",
            "telephone_number": "770-892-8332",
            "fax_number": "470-401-1105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRANDON MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-03",
        "last_updated": "2022-03-03",
        "certification_date": "2022-03-03",
        "status": "A",
        "authorized_official_last_name": "BRANDON",
        "authorized_official_first_name": "TERRENCE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-743-8036",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHCARE FACILITY REGULATION",
            "identifier": "060-R-2073",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "brandonmedicalgroup@gmail.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "none",
            "address_1": "3766 Chapel Cv",
            "city": "Douglasville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301352885",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Brandon Medical Group LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Bracey's Case 2 Case Management Services
• Sumir Mukesh Brahmbhatt, MD
• Brainbased, Inc.
• Crystal Marie Branch, FNP-BC
• Margaret Branch, LPN
• James Patrick Brannon, MD
• Tiffanie L Brantley-Wright, LPC
• Leah Marie Braswell, NURSE PRACTITIONER
• Natalie Ronnette Brathwaite, M.D.
• Lauren Rose Breidenbach, DPT

• Home Health Agency in Douglasville, GA
• Providers in Douglasville, GA by specialty
• Home Health Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 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.