Individual provider Active NPI

Brandon Scott Lee, DPT

  • Physical Therapist
  • Mandeville, LA
National Provider Identifier
1720392228
Registry record updated Jul 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
07807 Issued in LA
Practice address
4020 Lonesome Rd
Mandeville, LA 70448-7085
Phone
(985) 626-9591
Fax
(985) 626-9592
NPI assigned
Jul 27, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2010

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 07807 LA Primary

Addresses

Primary practice location

4020 Lonesome Rd
Mandeville, LA 70448-7085

Mailing address

4020 Lonesome Rd
Mandeville, LA 70448-7085
Phone (985) 626-9591

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101213000738 LA Practitioner - Physical Therapist in Private Practice 2163619446 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Landers Physical Therapy Services, LLCGroup PAC ID 4486625209, 2 clinicians

Practice addresses (Care Compare)

405 S Tyler St
Covington, LA 70433-3039
Phone (985) 809-9088

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
07807LAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Landers Physical Therapy Services, LLC Physical Therapist CurrentSince Sep 26, 2010 Accepting new patients

Locations

405 S Tyler St
Covington, LA 70433
Phone (337) 298-6240

4020 Lonesome Rd
Mandeville, LA 70448
Phone (985) 626-9591

4020 Lonesome Rd
Ste 2
Mandeville, LA 70448

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": "1280188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280188800000",
    "number": "1720392228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4020 LONESOME RD",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704487085",
            "telephone_number": "985-626-9591",
            "fax_number": "985-626-9592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4020 LONESOME RD",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704487085",
            "telephone_number": "985-626-9591",
            "fax_number": "985-626-9592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "BRANDON",
        "middle_name": "SCOTT",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-27",
        "last_updated": "2010-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "07807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mandeville, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.