Deandra Brown, OT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

OT3950 Issued in MS

Practice address

1301 W Government St Ste 104
Brandon, MS 39042-3196

Phone

(601) 591-7535

Fax

(601) 591-7540

NPI assigned

Aug 10, 2022

Last updated

Aug 10, 2022By the provider in NPPES

Sex

Female

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Peak Therapy LLC

  • Physical Therapist
  • Brandon, MS
  • NPI 1215896600
  NPD

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

{
    "created_epoch": "1660089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1962130732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 W BEACON ST",
            "city": "PHILADELPHIA",
            "state": "MS",
            "postal_code": "393503229",
            "telephone_number": "601-650-0002",
            "fax_number": "601-650-9902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 W GOVERNMENT ST STE 104",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390423196",
            "telephone_number": "601-591-7535",
            "fax_number": "601-591-7540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "DEANDRA",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-10",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "OT3950",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OT  LICENSE",
            "identifier": "OT3950",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "performancetherapy@rocketmail.com",
            "affiliation": "N",
            "endpointDescription": "Email for pt and employee info",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "pt info and employee info",
            "address_1": "921 W Beacon St",
            "city": "Philadelphia",
            "state": "MS",
            "country_code": "US",
            "postal_code": "393503229",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Brookshire Grocery Company (Brookshires Pharmacy #123)
• Ronetta Broomfield
• Alexis Brown, PS-CSS
• Ashley Karol Brown, MD
• Corey Nathaniel Brown, DO
• Joshua Scott Brown, PHARMD
• Julie Brown, PCMHT
• Nehemiah Levi Brown
• Shalia Ainsworth Brown
• Shannon C Brown, PCMHT, M.S, M. ED

• Physical Therapist in Brandon, MS
• Providers in Brandon, MS by specialty
• Physical Therapist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2022; 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.