Individual provider Active NPI

Brent Simpson

  • Physical Therapy Assistant
  • Jackson, TN
National Provider Identifier
1518403476
Registry record updated Jan 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
5423 Issued in TN
Practice address
85 Stonebrook PL
Ste B
Jackson, TN 38305-3652
Phone
(731) 664-7060
Fax
(731) 664-5005
NPI assigned
Jan 16, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2017

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 5423 TN Primary

Addresses

Primary practice location

85 Stonebrook PL
Ste B
Jackson, TN 38305-3652

Mailing address

85 Stonebrook PL
Ste B
Jackson, TN 38305-3652
Phone (731) 664-7060

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

State licenses

LicenseStateTypeSpecialty
5423TNMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson Madison County General Hospital Past Accepting new patients

Organizations & group practices 1

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": "1484524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484524800000",
    "number": "1518403476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 STONEBROOK PL",
            "address_2": "STE B",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383053652",
            "telephone_number": "731-664-7060",
            "fax_number": "731-664-5005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 STONEBROOK PL",
            "address_2": "STE B",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383053652",
            "telephone_number": "731-664-7060",
            "fax_number": "731-664-5005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMPSON",
        "first_name": "BRENT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-01-16",
        "last_updated": "2017-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TN",
            "license": "5423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2017; 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.