Breland Green, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11995 Issued in SC

Practice address

634 Bacons Bridge Rd
Summerville, SC 29485-4102

Phone

(843) 821-2272

NPI assigned

Aug 10, 2023

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

Enrolled in SC

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Imagine Physical Therapy in West Ashley LLCGroup PAC ID 6800072562, 3 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.

• Imagine Physical Therapy in West Ashley, LLC

  • Physical Therapy Clinic/Center
  • Charleston, SC
  • NPI 1588977862

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Imagine Physical Therapy LLC

  • Physical Therapist
  • Mt Pleasant, SC
  • NPI 1245241041
  Medicare reassignment NPD
• Imagine Physical Therapy North Rhett LLC

  • Physical Therapy Clinic/Center
  • North Charleston, SC
  • NPI 1033518766

  Physical Therapist

  Medicare reassignment NPD
• Imagine Physical Therapy Old Village LLC

  • Physical Therapy Clinic/Center
  • Mt Pleasant, SC
  • NPI 1477937662

  Physical Therapist

  Medicare reassignment NPD
• Imagine Physical Therapy on Daniel Island LLC

  • Physical Therapy Clinic/Center
  • Charleston, SC
  • NPI 1972770733

  Physical Therapist

  Medicare reassignment NPD
• Love of Language

  • Speech-Language Pathologist
  • Mt Pleasant, SC
  • NPI 1184163842
  NPD (past)

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

{
    "created_epoch": "1691625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1457034811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 EAGLE VIEW DR",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294145762",
            "telephone_number": "803-413-5921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "634 BACONS BRIDGE RD",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294854102",
            "telephone_number": "843-821-2272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "BRELAND",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-10",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "11995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan Granito
• Nakia Grant
• Te'on Grant
• Winter Aliah Grant, M.A.
• Greater Works of Mental Health
• Jasmine Evanna Green, D.M.D
• Keenan W. Green, D.M.D
• Martha R Green, MS PAS PA-C
• Monique L Green
• Neema N Green

• Physical Therapist in Summerville, SC
• Providers in Summerville, SC by specialty
• Physical Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2023; 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.