Brandie Bennett, PT,DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT4651 Issued in MS

Practice address

415 S 28TH Ave
Hattiesburg, MS 39401-7246

Phone

(601) 268-5757

Fax

(601) 579-5220

NPI assigned

Mar 10, 2014

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fox Rehab Agency Ms LLCGroup PAC ID 2769841782, 66 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Fox Rehab Agency Ms LLC

  • Physical Therapist
  • Starkville, MS
  • NPI 1336839000
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1394409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471910400000",
    "number": "1427474832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 S 28TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394017246",
            "telephone_number": "601-268-5757",
            "fax_number": "601-579-5240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 S 28TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394017246",
            "telephone_number": "601-268-5757",
            "fax_number": "601-579-5220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "BRANDIE",
        "credential": "PT,DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-10",
        "last_updated": "2016-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT4651",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01334696",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00536563",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tiffanie Suzanne Bellino, FNP
• Kimberly Bellipanni, BCBA-D
• Samantha Benigno, RBT
• Benjamin J. Hodges, D.M.D., P.a.
• Adam Bennett
• Jeremy A Bennett, DPT
• Leah Claire Bennett, PHD
• Megan Bensley, M.A. CCC/SLP
• Chris H Benson, MD
• Damea B Benton, MD

• Physical Therapist in Hattiesburg, MS
• Providers in Hattiesburg, MS by specialty
• Physical Therapist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2016; 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.