Individual provider Active NPI

Brandon John Adams, MPT CSCS

  • Physical Therapist
  • Myrtle Beach, SC
National Provider Identifier
1861597825
Registry record updated Nov 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
9239 Issued in SC
Practice address
7955 N Kings Hwy Ste 330
Myrtle Beach, SC 29572
Phone
(843) 945-1815
Fax
(843) 945-2343
NPI assigned
Sep 14, 2006
Last updated
Nov 16, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 10763 NC
Physical Therapist 225100000X 9239 SC Primary

Addresses

Primary practice location

7955 N Kings Hwy Ste 330
Myrtle Beach, SC 29572

Mailing address

1200 Corporate Dr Ste 400
Birmingham, AL 35242-5424
Phone (423) 238-7217

Other practice location 1

902 N Howe Street
Southport, NC 28461-3038
Phone (910) 457-4789

Other practice location 2

902 N Howe Street
Southport, NC 28461-3038
Phone (910) 457-4789

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20061214000453 NC Practitioner - Physical Therapist in Private Practice 6608875901 Reassigns benefits to 1 organization
I20181227001916 SC Practitioner - Physical Therapist in Private Practice 6608875901 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10763NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy in Motion of Oklahoma LLC Physical Therapist CurrentSince Jun 21, 2018 Accepting new patients
Benchmark Healthcare Services, LLC Physical Therapist CurrentSince Jul 30, 2018 Accepting new patients
Benchmark Health Services Physical Therapist CurrentSince Jul 30, 2018 Accepting new patients
Benchmark Healthcare Services, LLC Physical Therapist Current Accepting new patients
Physical Therapy Coach, Inc Physical Therapist Past Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

1000 Tanner Ford Blvd
Ste 370
Hanahan, SC 29410
Phone (843) 718-1058

7955 N Kings Hwy
Ste 330
Myrtle Beach, SC 29572
Phone (843) 945-1815

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542326400000",
    "number": "1861597825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352425424",
            "telephone_number": "423-238-7217",
            "fax_number": "423-238-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7955 N KINGS HWY STE 330",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "29572",
            "telephone_number": "843-945-1815",
            "fax_number": "843-945-2343"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "902 N Howe Street",
            "address_purpose": "LOCATION",
            "city": "Southport",
            "state": "NC",
            "postal_code": "284613038",
            "country_code": "US",
            "telephone_number": "910-457-4789",
            "fax_number": "910-457-5824",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "902 N Howe Street",
            "address_purpose": "LOCATION",
            "city": "Southport",
            "state": "NC",
            "postal_code": "284613038",
            "country_code": "US",
            "telephone_number": "910-457-4789",
            "fax_number": "910-457-5824",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ADAMS",
        "first_name": "BRANDON",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "MPT CSCS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2018-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "10763",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "9239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2018; 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.