Trevor Benjamin Brandt, DPT
Individual provider Active NPI Physical Therapist · Portland, TN
NPI 1487842639 · NPPES record last updated Oct 11, 2007
Key facts
- NPI
- 1487842639
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- Practice address
- 121 Village Dr
Suite 103
Portland, TN 37148-1418 - Phone
- (615) 323-7575
- NPI assigned
- Oct 11, 2007
- Sex
- Male
- Sole proprietor
- No
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)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7934 | TN | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Star Physical Therapy LP | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Yes |
Addresses
Primary practice location
121 Village Dr
Suite 103
Portland, TN 37148-1418
Mailing address
PO Box 681478
Franklin, TN 37068-1478
Phone (866) 800-9147
Other providers in Portland, TN
- Stephanie Bentley
- Latoya Blake
- Joshua Bland
- Lester Steve Blevins
- Donald W Blocker
- Sancia Renee Brooks
- Natalie Elizabeth Brown
- Jason A Bruns
- Felicia Butler
- Amanda Butterworth
All providers in Portland, TN · Physical Therapist in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 11, 2007. 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.