Individual provider Active NPI

Brandon Dale Callais, DPT

  • Physical Therapist
  • Slidell, LA
National Provider Identifier
1972809622
Registry record updated Sep 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
07995 Issued in LA
Practice address
200N Military Rd
Slidell, LA 70461-1624
Phone
(985) 641-2996
NPI assigned
Jan 28, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 07995 LA Primary

Addresses

Primary practice location

200N Military Rd
Slidell, LA 70461-1624

Mailing address

200N Military Rd
Slidell, LA 70461-1624
Phone (985) 641-2996

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110223001212 LA Practitioner - Physical Therapist in Private Practice 7113108101 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bennett Physical Therapy LLCGroup PAC ID 0547690125, 5 clinicians

Practice addresses (Care Compare)

2040 Gause Blvd E
Suite 6
Slidell, LA 70461-5453
Phone (985) 201-8075

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
07995LAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bennett Physical Therapy, LLC CurrentSince Jan 29, 2024 Accepting new patients
Physiofit Louisiana LLC Physical Therapist CurrentSince Apr 1, 2020 Accepting new patients

Locations

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

64167 Highway 41
Ste A
Pearl River, LA 70452
Phone (985) 250-9727

2965 Gause Blvd E
Slidell, LA 70461
Phone (985) 231-6475

2040 Gause Blvd E
Ste 6
Slidell, LA 70461
Phone (985) 201-8075

200 N Military Rd
Slidell, LA 70461
Phone (985) 590-5029

4038 Pontchartrain Dr
Slidell, LA 70458
Phone (985) 641-2996

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1296172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441929600000",
    "number": "1972809622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200N MILITARY RD",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704611624",
            "telephone_number": "985-641-2996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200N MILITARY RD",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704611624",
            "telephone_number": "985-641-2996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALLAIS",
        "first_name": "BRANDON",
        "middle_name": "DALE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-01-28",
        "last_updated": "2015-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "07995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Slidell, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.