Andrew M Brand

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

3262-19 Issued in WI

Practice address

2020 Cheyenne CT
Grafton, WI 53024-9368

Phone

(262) 375-1075

Fax

(262) 375-4975

NPI assigned

Mar 30, 2022

Sex

Male

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

State licenses

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.

• Body Renovation Physical Therapy SC

  • Physical Therapist
  • Grafton, WI
  • NPI 1871664243
  NPD
• Body Renovation Health Services, S.C.

  • Physical Therapy Clinic/Center
  • Grafton, WI
  • NPI 1023210812
  NPD (past)

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

{
    "created_epoch": "1648598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648598400000",
    "number": "1427798271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 CHEYENNE CT",
            "city": "GRAFTON",
            "state": "WI",
            "postal_code": "530249368",
            "telephone_number": "262-375-1075",
            "fax_number": "262-375-4975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 CHEYENNE CT",
            "city": "GRAFTON",
            "state": "WI",
            "postal_code": "530249368",
            "telephone_number": "262-375-1075",
            "fax_number": "262-375-4975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAND",
        "first_name": "ANDREW",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-30",
        "last_updated": "2022-03-30",
        "certification_date": "2022-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "3262-19",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Body Renovation Health Services, S.C.
• Body Renovation Physical Therapy SC
• Melinda C Bonilla-Puetz, MD
• Jacob Paul Boucher
• Brian William Bradley, PH.D.
• Caroline Marie Brandt, AGACNP-BC
• Allison Kimball Brown
• Kirk John Brown, M.D.
• Tamisha M Brown
• Richard W Bunting, MD

• All providers in Grafton, WI
• Physical Therapy Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 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.