Individual provider Active NPI

Alan D Brandis, PH.D.

  • Psychologist
  • Marietta, GA
National Provider Identifier
1902976491
Registry record updated Nov 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY001906 Issued in GA
Practice address
2520 Windy Hill Rd SE
Suite 203
Marietta, GA 30067-8664
Phone
(770) 953-6401
Fax
(770) 953-6015
NPI assigned
Nov 9, 2006
Last updated
Nov 2, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY001906 GA Primary

Addresses

Primary practice location

2520 Windy Hill Rd SE
Suite 203
Marietta, GA 30067-8664

Mailing address

2520 Windy Hill Rd SE
Suite 203
Marietta, GA 30067-8664
Phone (770) 953-6401

Other identifiers 2

IdentifierTypeStateIssuer
000662703FMedicaidGA
000662703BMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111208000807 GA Practitioner - Clinical Psychologist 5597930156 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Atlanta Area Psychological Associates, P.C.Group PAC ID 4587645635, 5 clinicians

Practice addresses (Care Compare)

2520 Windy Hill Rd SE
Suite 203
Marietta, GA 30067-8650
Phone (770) 953-6401

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY001906GAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanta Area Psychological Associates, P.C. Psychologist CurrentSince Jun 5, 1995 Accepting new patients

Locations

2520 Windy Hill Rd SE
Ste 203
Marietta, GA 30067
Phone (770) 953-6401

555 Sun Valley Dr
Ste K3
Roswell, GA 30076
Phone (770) 953-6401

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, 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": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288656000000",
    "number": "1902976491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2520 WINDY HILL RD SE",
            "address_2": "SUITE 203",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300678664",
            "telephone_number": "770-953-6401",
            "fax_number": "770-953-6015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2520 WINDY HILL RD SE",
            "address_2": "SUITE 203",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300678664",
            "telephone_number": "770-953-6401",
            "fax_number": "770-953-6015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANDIS",
        "first_name": "ALAN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-09",
        "last_updated": "2010-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "GA",
            "license": "PSY001906",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000662703F",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000662703B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.