Active NPI
Brandon M Tourtillott, PH.D. CCC-A
- Audiologist
- Wright Patterson AFB, OH
National Provider Identifier
1962571315
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 51590
- Practice address
- 2610 7TH St
Wright Patterson AFB, OH 45433-7901 - Phone
- (937) 255-4199
- NPI assigned
- Nov 7, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 51590 | TX | Primary |
Addresses
Primary practice location
2610 7TH St
Wright Patterson AFB, OH 45433-7901
Mailing address
2130 Crystal Marie Dr
Beavercreek, OH 45431-3314
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 51590 | TX | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1417392000000",
"number": "1962571315",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2130 CRYSTAL MARIE DR",
"city": "BEAVERCREEK",
"state": "OH",
"postal_code": "454313314"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2610 7TH ST",
"city": "WRIGHT PATTERSON AFB",
"state": "OH",
"postal_code": "454337901",
"telephone_number": "937-255-4199"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TOURTILLOTT",
"first_name": "BRANDON",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "PH.D. CCC-A",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-07",
"last_updated": "2014-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "TX",
"license": "51590",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wright Patterson AFB, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.