Individual provider Active NPI

Brandon Burns, PT

  • Physical Therapist
  • Augusta, GA
National Provider Identifier
1558874511
Registry record updated Nov 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
1600 Anthony Rd
Augusta, GA 30904-4824
Phone
(706) 738-3301
NPI assigned
Nov 13, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X GA Primary

Addresses

Primary practice location

1600 Anthony Rd
Augusta, GA 30904-4824

Mailing address

3712 Woodland Dr NW
Cleveland, TN 37312-3454

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200117002164 TN Practitioner - Physical Therapist in Private Practice 8123453222 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Champion Physical Therapy LLC Halls Physical Therapist CurrentSince Oct 6, 2019 Accepting new patients
Champion Physical Therapy, LLC CurrentSince Oct 6, 2019 Accepting new patients

Locations

1110 Shawnee Rd
Lima, OH 45805
Phone (419) 221-6720

7228 Norris Fwy
Knoxville, TN 37918
Phone (865) 377-3176

Organizations & group practices 2

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": "1510531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510531200000",
    "number": "1558874511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3712 WOODLAND DR NW",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373123454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 ANTHONY RD",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309044824",
            "telephone_number": "706-738-3301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNS",
        "first_name": "BRANDON",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-11-13",
        "last_updated": "2017-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.