Individual provider Active NPI

Brandon Charles Dennis, PSY.D.

  • Clinical Neuropsychologist
  • Louisville, KY
National Provider Identifier
1457679276
Registry record updated Apr 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
1654 Issued in KY
Practice address
4950 Norton Healthcare Blvd Ste 305
Louisville, KY 40241
Phone
(502) 394-6460
Fax
(502) 394-6465
NPI assigned
May 5, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 1654 KY
Clinical Neuropsychologist 103G00000X 1654 KY Primary

Addresses

Primary practice location

4950 Norton Healthcare Blvd Ste 305
Louisville, KY 40241

Mailing address

PO Box 776351
Chicago, IL 60677-6351
Phone (502) 588-9490

Other practice location 1

4950 Norton Healthcare Blvd Ste 305
Louisville, KY 40241
Phone (502) 394-6460

Other identifiers 4

IdentifierTypeStateIssuer
7100435060 (KOHMG)MedicaidKY
201398770A (KOHMG)MedicaidIN
K214080-KOHMGOtherKYMEDICARE
P017311-KOHMGOtherKYRR MEDICARE

Electronic endpoints 3

TypeEndpointUseAffiliation
FHIR URL https://epicsoap.nortonhealthcare.org/FHIRPRD/api/FHIR/DSTU2/
FHIR URL https://epicsoap.nortonhealthcare.org/FHIRPRD/api/FHIR/DSTU2/
Direct Messaging Address bdennis160726@direct.nortonhealthcare.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161019002018 KY Practitioner - Clinical Psychologist 6406144765 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Medical Associates IncGroup PAC ID 7012811284, 1,368 clinicians

Practice addresses (Care Compare)

825 Barret Ave
Louisville, KY 40204-1743
Phone (502) 272-5165

Merit-based Incentive Payment System (MIPS)

Final score
81.11 of 100Reported as group
Quality
63.34
Promoting interoperability
100
Improvement activities
40
Cost
73.68

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1654KYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medical Associates, Inc. Clinical Neuropsychologist Current Accepting new patients
Community Medical Associates, Inc. CurrentSince Jun 25, 2019 Accepting new patients
Community Medical Associates, Inc. Clinical Neuropsychologist CurrentSince Jun 25, 2019 Accepting new patients
Community Medical Associates, Inc. Clinical Neuropsychologist Past Accepting new patients

Locations

825 Barret Ave
Louisville, KY 40204
Phone (502) 272-5165

4950 Norton Healthcare Blvd
Ste 305
Louisville, KY 40241
Phone (502) 394-6440

4915 Norton Healthcare Blvd
Ste 301
Louisville, KY 40241
Phone (502) 394-6390

Interoperability endpoints

  • Direct secure messaging: bdennis160726@direct.nortonhealthcare.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1273017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1457679276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776351",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776351",
            "telephone_number": "502-588-9490",
            "fax_number": "502-272-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4950 NORTON HEALTHCARE BLVD STE 305",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40241",
            "telephone_number": "502-394-6460",
            "fax_number": "502-394-6465"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4950 Norton Healthcare Blvd Ste 305",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "40241",
            "country_code": "US",
            "telephone_number": "502-394-6460",
            "fax_number": "502-394-6465",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DENNIS",
        "first_name": "BRANDON",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-05",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "KY",
            "license": "1654",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "KY",
            "license": "1654",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100435060 (KOHMG)",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201398770A (KOHMG)",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "K214080-KOHMG",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P017311-KOHMG",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicsoap.nortonhealthcare.org/FHIRPRD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "4950 Norton Healthcare Blvd Ste 305",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "40241",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicsoap.nortonhealthcare.org/FHIRPRD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "4950 Norton Healthcare Blvd Ste 305",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "40241",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bdennis160726@direct.nortonhealthcare.org",
            "affiliation": "N",
            "address_1": "4950 Norton Healthcare Blvd Ste 305",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "40241",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.