Brandon Lee Bussa, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

05013875A Issued in IN

Practice address

4411 S Adams St
Marion, IN 46953-5349

Phone

(765) 674-4455

Fax

(765) 674-3577

NPI assigned

Sep 14, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• The Center for Sports & Physical Therapy

  • Physical Therapist
  • Marion, IN
  • NPI 1811014681
  NPD
• Indiana Wesleyan University

  • Physical Therapist
  • Wabash, IN
  • NPI 1316874522
  NPD (past)

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

{
    "created_epoch": "1600041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600041600000",
    "number": "1932714276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4411 S ADAMS ST",
            "city": "MARION",
            "state": "IN",
            "postal_code": "469535349",
            "telephone_number": "765-674-4455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4411 S ADAMS ST",
            "city": "MARION",
            "state": "IN",
            "postal_code": "469535349",
            "telephone_number": "765-674-4455",
            "fax_number": "765-674-3577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSSA",
        "first_name": "BRANDON",
        "middle_name": "LEE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-14",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05013875A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100124000",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelina Burrows, LCSW
• Vivian Burt, SOCIAL WORK
• Kenzie Burton, RBT
• Rhonda Kay Bush, LPN
• Trisha Bush, MSW
• Jaden Bussert, RBT
• Alice Matilda Butterworth, D.D.S.
• Renee Lynn Buttler, OTR
• Ivory Bynum, RBT
• Mariah Cade, RBT

• Physical Therapist in Marion, IN
• Providers in Marion, IN by specialty
• Physical Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2020; 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.