Caroline Malone Brannen, PT, DPT
Individual provider Active NPI Physical Therapist · Norcross, GA
NPI 1467066563 · NPPES record last updated Feb 6, 2023
Key facts
- NPI
- 1467066563
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT014934 (GA)
- Practice address
- 3985 Steve Reynolds Blvd BLDG G
Norcross, GA 30093-3001 - Phone
- (770) 622-2532
- NPI assigned
- Sep 4, 2020
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT014934 | GA | MD | Pediatric Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Atlanta International PT, Inc | Physical Therapist | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | PT014934 | GA | |
| Physical Therapist | 225100000X | PT014934 | GA | Yes |
Addresses
Primary practice location
3985 Steve Reynolds Blvd BLDG G
Norcross, GA 30093-3001
Mailing address
3642 N Kimberly Dr
Atlanta, GA 30340-4316
Phone (404) 281-3058
Other practice location 1
4900 Ivey Rd NW Ste 1720
Acworth, GA 30101-4101
Phone (770) 917-5737
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PT014934 | Other | GA | GEORGIA STATE BOARD OF PHYSICAL THERAPY |
Other names
- Caroline Amanda Malone
Other providers in Norcross, GA
- Braces Now 14, LLC
- D'Alma Bradley
- Brain Positive Therapy, LLC
- Ciandra Regine Calhoun Branch
- Technara Branchedor
- Brave Tomorrow Counseling and Consulting
- Juana M Braverman
- Breakthrough Addiction Recovery
- Tanayah Breeden
- Patricia Brennen
All providers in Norcross, GA · Physical Therapist in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 6, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.