Individual provider Active NPI

Brandan Lee Hostar, PTA

  • Physical Therapy Assistant
  • Columbia, SC
National Provider Identifier
1457170110
Registry record updated Oct 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
Practice address
3800 Forest Dr Ste B101
Columbia, SC 29204-4146
Phone
(803) 764-2363
Fax
(803) 550-9389
NPI assigned
Oct 8, 2024
Last updated
Oct 8, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X SC Primary

Addresses

Primary practice location

3800 Forest Dr Ste B101
Columbia, SC 29204-4146

Mailing address

150 Highland Center Dr Ste B
Columbia, SC 29203-9247
Phone (803) 699-9775

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1728345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1457170110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 HIGHLAND CENTER DR STE B",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292039247",
            "telephone_number": "803-699-9775",
            "fax_number": "803-699-8099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 FOREST DR STE B101",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292044146",
            "telephone_number": "803-764-2363",
            "fax_number": "803-550-9389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOSTAR",
        "first_name": "BRANDAN",
        "middle_name": "LEE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-10-08",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2024; 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.